Evaluation of CITED1, SIX1, and CD56 protein expression for identification of blastemal elements in Wilms tumor.
OBJECTIVE
Successful further treatment of Wilms tumors (WTs) after preoperative chemotherapy and surgery depends on correct histopathologic risk stratification, including quantification of remaining blastemal elements. In the present study, we assessed the usefulness of protein markers for the detection of WT blastema.


METHODS
Expression of the candidate blastemal protein markers CITED1, SIX1, and CD56 was evaluated by immunofluorescence regarding sensitivity and specificity for staining blastema in a tissue microarray containing cores from 30 WTs, a small number of rarer pediatric renal neoplasms, and normal postnatal kidney.


RESULTS
CITED1, SIX1, and CD56 were expressed in blastema in 100%, 89%, and 74%, respectively, of the WTs with this component present. However, they were also expressed in 64%, 25%, and 79%, respectively, of epithelial WT elements and 48%, 52%, and 62%, respectively, of stromal WT elements.


CONCLUSIONS
SIX1 showed the highest specificity, CITED1 the highest sensitivity, and CD56 low specificity and sensitivity for detection of postchemotherapy WT blastema. Cytokeratin staining proved to be a useful way to determine rudimentary tubular elements not readily recognized by routine staining.
From the Department of Clinical Genetics, Lund University, Lund, Sweden; and sehic@med.lu.se.
Daniel
D
Sehic
Department of Pathology, Skåne University, and Regional Laboratories, Lund, Sweden.
Cristina D
CD
Ciornei
From the Department of Clinical Genetics, Lund University, Lund, Sweden; and Department of Pathology, Skåne University, and Regional Laboratories, Lund, Sweden.
David
D
Gisselsson
D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D000293:Adolescent; D000368:Aged; D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor / Q000378:metabolism*; D019002:CD56 Antigen / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000378:metabolism / Q000473:pathology*; D008297:Male; D018201:Nephroma, Mesoblastic / Q000378:metabolism / Q000473:pathology; D009687:Nuclear Proteins / Q000378:metabolism*; D018335:Rhabdoid Tumor / Q000378:metabolism / Q000473:pathology; D018227:Sarcoma, Clear Cell / Q000378:metabolism / Q000473:pathology; D012680:Sensitivity and Specificity; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D015534:Trans-Activators; D014157:Transcription Factors / Q000378:metabolism*; D009396:Wilms Tumor / Q000378:metabolism / Q000473:pathology*
D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor; D019002:CD56 Antigen; C512688:CITED1 protein, human; D018398:Homeodomain Proteins; C522918:NCAM1 protein, human; D009687:Nuclear Proteins; C099236:SIX1 protein, human; D015534:Trans-Activators; D014157:Transcription Factors
Blastema; CD56; CITED1; Immunofluorescence; Nephroblastoma; SIX1; Wilms tumor