Immunohistochemical differential diagnosis between thymic carcinoma and type B3 thymoma: diagnostic utility of hypoxic marker, GLUT-1, in thymic epithelial neoplasms.
There are only a few immunohistochemical markers that are useful for differentiating thymic carcinomas from type B3 thymomas. The purpose of this study is to examine the additional markers that would be useful for differentiating between thymic carcinoma and thymoma type B3. We performed a tissue microarray analysis of surgically resected thymic tumor specimens from 12 cases of thymic carcinoma, 7 cases of type B3 thymoma, and 68 cases of other types of thymoma. Immunostaining using 49 antibodies was scored based on staining intensity and the percentage of cells that stained positive. Seven proteins that were selected by the staining scores, namely, GLUT-1 (167 vs 4), CA-IX (110 vs 15), c-kit (162 vs 44), CD5 (33 vs 0), MUC-1 (54 vs 0), CEA (42 vs 0), and CK18 (110 vs 42), were significantly higher in the thymic carcinomas than in the type B3 thymomas. The staining sensitivity and specificity of the antibodies for thymic carcinoma were GLUT-1, sensitivity 72% and specificity 100%; CA-IX, 58 and 71%; c-kit, 72 and 85%; CD5, 33 and 100%; CK18, 58 and 71%; MUC-1, 25 and 100%; and CEA, 33 and 100%. Glucose transporter 1 (GLUT-1) is the best marker for thymic carcinoma because it had the highest sensitivity and specificity. Positive immunostaining for a combination of three markers, namely, GLUT-1, CD5, and CEA, enabled differentiation of thymic carcinoma with 91.6% sensitivity and 100% specificity. In conclusion, we identified GLUT-1 as an additional marker that will be useful for differentiating thymic carcinoma from type B3 thymoma, especially in biopsy specimens that have been crushed or are otherwise difficult to examine morphologically in thymic tumors.
Kojika
Masakazu
M
Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan.
Ishii
Genichiro
G
Yoshida
Junji
J
Nishimura
Mituyo
M
Hishida
Tomoyuki
T
Ota
Shu-ji
SJ
Murata
Yukinori
Y
Nagai
Kanji
K
Ochiai
Atsushi
A
D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D018956:CD5 Antigens / Q000032:analysis; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D003937:Diagnosis, Differential; D051272:Glucose Transporter Type 1 / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D053538:Keratin-18 / Q000032:analysis; D018396:Mucin-1 / Q000032:analysis; D011237:Predictive Value of Tests; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D012680:Sensitivity and Specificity; D013934:Thymectomy; D013945:Thymoma / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D013953:Thymus Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D046888:Tissue Array Analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018956:CD5 Antigens; D002272:Carcinoembryonic Antigen; D051272:Glucose Transporter Type 1; C488421:KRT18 protein, human; D053538:Keratin-18; C060192:MUC1 protein, human; D018396:Mucin-1; C495677:SLC2A1 protein, human; D019009:Proto-Oncogene Proteins c-kit; C089226:CA9 protein, human; D000071231:Carbonic Anhydrase IX; D002256:Carbonic Anhydrases