title: Quantitative ELISA-Like Immunohistochemistry of Fibroblast Growth Factor 23 in Diagnosis of Tumor-Induced Osteomalacia and Clinical Characteristics of the Disease.
abstract: Tumor-induced osteomalacia (TIO) is a rare acquired paraneoplastic disorder and fibroblast growth factor 23 (FGF23) plays a key role in its pathogenesis. This study was conducted to describe a novel FGF23 detecting procedure and describe clinical features of the disease. Fourteen TIO cases were retrieved and FGF23 expression was measured by quantitative ELISA-like immunohistochemistry using formalin-fixed and paraffin-embedded tissues. As summarized from 14 TIO cases, clinical features of TIO were long-standing history of osteomalacia, hypophosphatemia, and urinary phosphate wasting. The associated tumors were mostly benign phosphaturic mesenchymal tumors mixed connective tissue variant (PMTMCT) which could be located anywhere on the body, and most of them could be localized by conventional examinations and octreotide scanning. By quantitative ELISA-like immunohistochemistry, all the 14 TIO cases had high FGF23 expression (median 0.69, 25%-75% interquartile 0.57-1.10, compared with 26 non-TIO tumors of median 0.07, 25%-75% interquartile 0.05-0.11, p < 0.001). The quantitative ELISA-like immunohistochemistry was a feasible and reproducible procedure to detect the high FGF23 expression in formalin-fixed and paraffin-embedded biopsies or specimens. Since TIO was often delay-diagnosed or misdiagnosed, clinicians and pathologists should be aware of TIO and PMTMCT, respectively.
authors.affiliation: Department of Orthopedics, Tianjin Hospital, Tianjin 300211, China.
authors.forename: Fangke
authors.initials: F
authors.lastname: Hu
authors.affiliation: Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
authors.forename: Chengying
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Huaiyin
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Pathology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yan
authors.identifier: 0000-0001-9599-6901
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009372:Neoplasms, Connective Tissue / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D015203:Reproducibility of Results; D015854:Up-Regulation; D055815:Young Adult
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23