title: Differentiating primary and extragenital metastatic mucinous ovarian tumours: an algorithm combining PAX8 with tumour size and laterality.
abstract: OBJECTIVE
  Our aim was to analyse the utility of the algorithm combining PAX8 with clinicopathological characteristics (tumour size, laterality and patient age) in differentiating primary ovarian mucinous tumours (POMTs) from extragenital metastatic mucinous carcinomas involving the ovary (eMOMCs).
  
  
  RESULTS
  Immunohistochemical staining for PAX8 was performed on formalin ﬁxed, parafﬁn embedded tissues from 47 POMTs, 18 eMOMCs and 70 extragenital primary mucinous carcinomas (ePMCs) using anti-PAX8 rabbit polyclonal antibody (pAb) and anti-PAX8 rabbit monoclonal antibody (mAb). PAX8 (pAb) positive signals were found in 3/18 eMOMCs and in 32/70 ePMCs. PAX8 (mAb) demonstrated superior specificity, with 0% positivity in both eMOMCs and ePMCs, but unfavourable sensitivity, with 60.9% in ovarian mucinous borderline tumours and 45.8% in POMCs. Although PAX8 (mAb) immunostaining status (66.2%), tumour size (75.4%) and laterality (84.6%) demonstrated unsatisfactory accuracy when they were evaluated individually in differentiating POMTs from eMOMCs, a combination of PAX8 (mAb) immunostaining status, tumour size and laterality markedly increased accuracy (86.2%), with a satisfactory Youden Index (63.7%).
  
  
  CONCLUSIONS
  PAX8 (mAb) was a specific marker in differentiating POMTs from eMOMCs. As a simple, convenient and high performance to price ratio algorithm, a combination of PAX8 (mAb) immunostaining with tumour size and laterality will improve the diagnostic criteria of ovarian mucinous metastasis.
authors.affiliation: Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Centre, Beijing, China.
authors.forename: Ajin
authors.initials: A
authors.lastname: Hu
authors.affiliation: Department of Pathology, Beijing Chuiyangliu Hospital, Beijing, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Centre, Beijing, China.
authors.forename: Letian
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Histology and Embryology, Peking University Health Science Centre, Beijing, China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Ren
authors.affiliation: Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Centre, Beijing, China.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Centre, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology, School of Basic Medical Science, Peking University Third Hospital, Peking University Health Science Centre, Beijing, China.
authors.forename: Congrong
authors.initials: C
authors.lastname: Liu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000737:chemistry* / Q000473:pathology* / Q000556:secondary; D000367:Age Factors; D000465:Algorithms; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000473:pathology* / Q000556:secondary; D000072636:PAX8 Transcription Factor; D051761:Paired Box Transcription Factors / Q000032:analysis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D000072636:PAX8 Transcription Factor; C083325:PAX8 protein, human; D051761:Paired Box Transcription Factors
keywords: CANCER RESEARCH; GYNAECOLOGICAL PATHOLOGY; IMMUNOHISTOCHEMISTRY
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