Swati Bhardwaj, Brandon Veremis, Rocco Fernandino, Marshall Posner, William H Westra
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In addition, 2 clinically matched cohorts of aggressive (n=28) versus nonaggressive (n=26) HPV-OPSCCs were retrospectively stained with the INSM1 and synaptophysin to determine the prognostic significance of INSM1 staining. In all, 42% of HPV-OPSCC showed positive INSM1 staining, but synaptophysin was not co-expressed in even a single case. In selected cases based on clinical behavior, INSM1 staining was observed more frequently in nonaggressive than aggressive tumors (50.0% vs. 21.4%, P =0.03). INSM1 expression is a common finding in HPV-OPSCC and is usually not linked with true NE transformation or aggressive behavior. Indeed, INSM1 expression is more commonly observed in nonaggressive cancers. 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引用次数: 0
摘要
INSM1 已迅速成为神经内分泌(NE)分化的可靠标记物,这促使人们将 INSM1 用作不同部位 NE 分化的独立标记物。INSM1 染色在评估与 HPV 相关的口咽鳞状细胞癌(HPV-OPSCCs)时可能是一种特别实用的工具,因为高分化的 NE 虽然预示着极具侵袭性的临床表现,但仅从形态学角度来看却很难识别。本研究的目的是确定 INSM1 在 HPV-OPSCC 中的表达率,并研究其在决定 NE 转变和临床侵袭性中的作用。研究人员用 INSM1 和突触素对 46 例连续的非筛选 HPV-OPSCC 进行了染色。此外,对两组临床匹配的侵袭性(28 例)和非侵袭性(26 例)HPV-OPSCC 进行了 INSM1 和突触素染色,以确定 INSM1 染色的预后意义。总共有42%的HPV-OPSCC显示INSM1染色阳性,但突触素在任何病例中都没有共同表达。在根据临床表现筛选出的病例中,非侵袭性肿瘤比侵袭性肿瘤更常出现 INSM1 染色(50.0% 对 21.4%,P=0.03)。INSM1表达是HPV-OPSCC的常见发现,通常与真正的NE转化或侵袭性行为无关。事实上,INSM1的表达在非侵袭性癌症中更为常见。仅依靠 INSM1 染色来识别 HPV-OPSCC 中的 NE 分化可能会带来灾难性后果。
The Common Expression of INSM1 in HPV-related Oropharyngeal Squamous Cell Carcinomas Is Not Associated With True Neuroendocrine Transformation or Aggressive Behavior.
INSM1 has rapidly emerged as a robust marker for neuroendocrine (NE) differentiation, prompting the use of INSM1 as a standalone marker for NE differentiation in various sites. INSM1 staining could be an especially practical tool for evaluating HPV-associated oropharyngeal squamous cell carcinoma (HPV-OPSCCs) because high-grade NE transformation may be exceedingly difficult to recognize on morphologic grounds alone, even though it portends highly aggressive clinical behavior. The purpose of this study was to determine the incidence of INSM1 expression in HPV-OPSCC and study its role in determining NE transformation and clinical aggressiveness. Forty-six consecutive nonselected HPV-OPSCCs were stained with INSM1 and synaptophysin. In addition, 2 clinically matched cohorts of aggressive (n=28) versus nonaggressive (n=26) HPV-OPSCCs were retrospectively stained with the INSM1 and synaptophysin to determine the prognostic significance of INSM1 staining. In all, 42% of HPV-OPSCC showed positive INSM1 staining, but synaptophysin was not co-expressed in even a single case. In selected cases based on clinical behavior, INSM1 staining was observed more frequently in nonaggressive than aggressive tumors (50.0% vs. 21.4%, P =0.03). INSM1 expression is a common finding in HPV-OPSCC and is usually not linked with true NE transformation or aggressive behavior. Indeed, INSM1 expression is more commonly observed in nonaggressive cancers. Reliance on INSM1 staining alone in recognizing NE differentiation in HPV-OPSCC could be calamitous.
期刊介绍:
The American Journal of Surgical Pathology has achieved worldwide recognition for its outstanding coverage of the state of the art in human surgical pathology. In each monthly issue, experts present original articles, review articles, detailed case reports, and special features, enhanced by superb illustrations. Coverage encompasses technical methods, diagnostic aids, and frozen-section diagnosis, in addition to detailed pathologic studies of a wide range of disease entities.
Official Journal of The Arthur Purdy Stout Society of Surgical Pathologists and The Gastrointestinal Pathology Society.