title: ZBTB16: a novel sensitive and specific biomarker for yolk sac tumor.
abstract: Although the function of zinc finger and BTB domain containing 16 (ZBTB16) in spermatogenesis is well documented, expression of ZBTB16 in germ cell tumors has not yet been studied. The aim of this study was to investigate the immunohistochemical expression and diagnostic utility of ZBTB16 in germ cell tumors. A total of 67 adult germ cell tumors were studied (62 testicular germ cell tumors, 2 ovarian yolk sac tumors, 1 mediastinal yolk sac tumor, and 2 retroperitoneal metastatic yolk sac tumors). The 62 testicular primary germ cell tumors are as follows: 34 pure germ cell tumors (20 seminomas, 8 embryonal carcinomas, 2 teratomas, 1 choriocarcinoma, 1 carcinoid, and 2 spermatocytic tumors) and 28 mixed germ cell tumors (composed of 13 embryonal carcinomas, 15 yolk sac tumors, 15 teratomas, 7 seminomas, and 3 choriocarcinomas in various combinations). Thirty-five cases contained germ cell neoplasia in situ. Yolk sac tumor was consistently reactive for ZBTB16. Among the 15 testicular yolk sac tumors in mixed germ cell tumors, all displayed moderate to diffuse ZBTB16 staining. ZBTB16 reactivity was present regardless of the histologic patterns of yolk sac tumor and ZBTB16 was able to pick up small foci of yolk sac tumor intermixed/embedded in other germ cell tumor subtype elements. Diffuse ZBTB16 immunoreactivity was also observed in 2/2 metastatic yolk sac tumors, 1/1 mediastinal yolk sac tumor, 2/2 ovarian yolk sac tumors, 2/2 spermatocytic tumors, 1/1 carcinoid, and the spermatogonial cells. All the other non-yolk sac germ cell tumors were nonreactive, including seminoma (n=27), embryonal carcinoma (n=21), teratoma (n=17), choriocarcinoma (n=4), and germ cell neoplasia in situ (n=35). The sensitivity and specificity of ZBTB16 in detecting yolk sac tumor among the germ cell tumors was 100% (20/20) and 96% (66/69), respectively. In conclusion, ZBTB16 is a highly sensitive and specific marker for yolk sac tumor.
authors.affiliation: Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Guang-Qian
authors.initials: GQ
authors.lastname: Xiao
authors.affiliation: Department of Pathology, University of Minnesota, Twin Cities, MN, USA.
authors.forename: Faqian
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Pathology, Lenox Hill Hospital-NS/LIJ Health System, New York, NY, USA.
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Unger
authors.affiliation: Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Hani
authors.initials: H
authors.lastname: Katerji
authors.affiliation: Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Loralee
authors.initials: L
authors.lastname: McMahon
authors.affiliation: Department of Pathology, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Burstein
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D018240:Endodermal Sinus Tumor / Q000737:chemistry* / Q000556:secondary; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008479:Mediastinal Neoplasms / Q000737:chemistry* / Q000473:pathology; D009373:Neoplasms, Germ Cell and Embryonal / Q000737:chemistry* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000473:pathology; D011237:Predictive Value of Tests; D000075722:Promyelocytic Leukemia Zinc Finger Protein / Q000032:analysis*; D015203:Reproducibility of Results; D012186:Retroperitoneal Neoplasms / Q000737:chemistry* / Q000473:pathology; D013736:Testicular Neoplasms / Q000737:chemistry* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D000075722:Promyelocytic Leukemia Zinc Finger Protein; C092037:ZBTB16 protein, human