title: Nuclear factor-erythroid 2, nerve growth factor receptor, and CD34-microvessel density are differentially expressed in primary myelofibrosis, polycythemia vera, and essential thrombocythemia.
abstract: Because of the presence of various overlapping findings, the discrimination of polycythemia vera (PV) from prefibrotic/fibrotic primary myelofibrosis (PF/F-PMF) and essential thrombocythemia (ET) may be challenging, particularly in suboptimal bone marrow biopsy specimens. In this study, we assessed whether differences in the expression of nuclear factor-erythroid 2 (NF-E2), nerve growth factor receptor (NGFR; CD271), CD34, CD68, p53, CD3, CD20, and CD138 by immunohistochemistry could be useful in separating among them. Higher frequencies of nuclear positive erythroblasts with NF-E2 were observed in ET and PV cases (50% ± 13.3% and 41.5% ± 9.4%, respectively) when compared with both PF-PMF (21% ± 11.7%) and F-PMF (28.5% ± 10.8%). We found that with a cutoff level of at least 30% nuclear staining for NF-E2 in erythroblasts, we could reliably exclude the possibility of PMF. Conversely, NGFR+ stromal cells per high-power field (HPF) was significantly increased in F-PMF (53.5 ± 19.1/HPF) and PF-PMF (13.5 ± 3.8/HPF) compared with ET (4.4 ± 2.2/HPF) and PV (6.6 ± 3.3/HPF). Similarly, differences in CD34-microvessel density was remarkable in F-PMF and PF-PMF cases in comparison with PV and ET (49.9 ± 12.1/HPF, 29.3 ± 12.4/HPF, 13.7 ± 4.6/HPF, and 11.9 ± 5.1/HPF, respectively). Thus, the assessment of NF-E2 and NGFR expression and the evaluation of CD34-microvessel density may provide additional support in reaching a correct diagnosis in these cases of myeloproliferative neoplasms.
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY 10065; Department of Pathology, Gulhane Military Medical Academy and School of Medicine, Ankara 06010, Turkey. Electronic address: nuy2001@med.cornell.edu.
authors.forename: Nuri
authors.initials: N
authors.lastname: Yigit
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY 10065. Electronic address: shc9107@nyp.org.
authors.forename: Shannon
authors.initials: S
authors.lastname: Covey
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY 10065. Electronic address: shb2016@med.cornell.edu.
authors.forename: Sharon
authors.initials: S
authors.lastname: Barouk-Fox
authors.affiliation: Department of Pathology, Gulhane Military Medical Academy and School of Medicine, Ankara 06010, Turkey. Electronic address: tturker@gata.edu.tr.
authors.forename: Turker
authors.initials: T
authors.lastname: Turker
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY 10065. Electronic address: jut9021@med.cornell.edu.
authors.forename: Julia Turbiner
authors.initials: JT
authors.lastname: Geyer
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY 10065. Electronic address: ato9002@med.cornell.edu.
authors.forename: Attilio
authors.initials: A
authors.lastname: Orazi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000096:biosynthesis; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D050984:NF-E2 Transcription Factor, p45 Subunit / Q000096:biosynthesis*; D009419:Nerve Tissue Proteins / Q000096:biosynthesis*; D011087:Polycythemia Vera / Q000175:diagnosis*; D055728:Primary Myelofibrosis / Q000175:diagnosis*; D017475:Receptors, Nerve Growth Factor / Q000096:biosynthesis*; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; D050984:NF-E2 Transcription Factor, p45 Subunit; C494692:NFE2 protein, human; C484065:NGFR protein, human; D009419:Nerve Tissue Proteins; D017475:Receptors, Nerve Growth Factor
keywords: Marrow stromal cells; Microvessel density; Myeloproliferative neoplasms; NF-E2; NGFR