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Napsin A and WT 1 are useful immunohistochemical markers for differentiating clear cell carcinoma ovary from high-grade serous carcinoma.

Abstract Clear cell carcinoma (CCC) of the ovary is an uncommon, but an aggressive epithelial ovarian cancer (EOC), which has overlapping histopathologic features with other ovarian tumours. Lately, Napsin A has been identified as its useful diagnostic immunohistochemical (IHC) marker. Fifty-eight prospectively diagnosed ovarian CCCs, 53 high-grade serous carcinomas (HGSCs), 16 endometrioid adenocarcinomas (EMACs), six mixed carcinomas, containing components of CCC and EMAC, seven metastatic mucinous adenocarcinomas and six ovarian yolk sac tumours (YSTs) were tested for Napsin A immunostaining. Fifty ovarian CCCs, 50 HGSCs, seven ovarian EMACs and five mixed carcinomas were tested for WT1 immunostaining. Napsin A was positively expressed in all 58 (100%) CCCs; was focally positive in 1 of 6 YSTs; in 1/16 EMACs and in six cases of mixed carcinomas, while it was negative in all 53 HGSCs and in seven metastatic mucinous adenocarcinomas. Other IHC markers expressed in cases of CCC ovary were CK7 (31/31) (100%), WT1 (0/50), p53 (20/26, 'wild type'), ER (4/31, focal) (12.9%), PAX8 (14/14) (100%), glypican-3 (4/10, focal) (44.4%), p16INK4 (5/5, focal) and CK20 (0/5). Various IHC markers expressed in HGSCs were WT1 (48/50) (96%), p53 (31/31, mostly 'mutation type'), CK7 (9/9) (100%) ER (13/16, variable) (81.2%) and PAX8 (14/14) (100%). IHC markers expressed in EMACs were ER (15/16) (93.7%), CK7 (2/2) (100%) and WT1 (0/7). IHC markers expressed in mixed carcinomas were CK7 (2/2) (100%), WT1 (0/2), focal Napsin A (6/6) and focal ER (5/6). The sensitivity and specificity of Napsin A for the diagnosis of CCC ovary was 100% and 90.9%, respectively. The sensitivity and specificity of WT1 for diagnosis of HGSC ovary was found to be 96% and 100%, respectively. Napsin A and WT1 are highly sensitive and specific IHC markers for diagnosing ovarian CCCs and HGSCs, respectively, and in differentiating these tumours from their mimics. Napsin A is useful in identification of component of CCC in certain EMACs.
PMID
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Authors

Mayor MeshTerms
Keywords

Napsin A

WT1

clear cell carcinoma

epithelial ovarian cancers

high-grade serous carcinoma

immunohistochemistry

Journal Title apmis : acta pathologica, microbiologica, et immunologica scandinavica
Publication Year Start




PMID- 29266433
OWN - NLM
STAT- MEDLINE
DCOM- 20180108
LR  - 20180108
IS  - 1600-0463 (Electronic)
IS  - 0903-4641 (Linking)
VI  - 126
IP  - 1
DP  - 2018 Jan
TI  - Napsin A and WT 1 are useful immunohistochemical markers for differentiating
      clear cell carcinoma ovary from high-grade serous carcinoma.
PG  - 45-55
LID - 10.1111/apm.12784 [doi]
AB  - Clear cell carcinoma (CCC) of the ovary is an uncommon, but an aggressive
      epithelial ovarian cancer (EOC), which has overlapping histopathologic features
      with other ovarian tumours. Lately, Napsin A has been identified as its useful
      diagnostic immunohistochemical (IHC) marker. Fifty-eight prospectively diagnosed 
      ovarian CCCs, 53 high-grade serous carcinomas (HGSCs), 16 endometrioid
      adenocarcinomas (EMACs), six mixed carcinomas, containing components of CCC and
      EMAC, seven metastatic mucinous adenocarcinomas and six ovarian yolk sac tumours 
      (YSTs) were tested for Napsin A immunostaining. Fifty ovarian CCCs, 50 HGSCs,
      seven ovarian EMACs and five mixed carcinomas were tested for WT1 immunostaining.
      Napsin A was positively expressed in all 58 (100%) CCCs; was focally positive in 
      1 of 6 YSTs; in 1/16 EMACs and in six cases of mixed carcinomas, while it was
      negative in all 53 HGSCs and in seven metastatic mucinous adenocarcinomas. Other 
      IHC markers expressed in cases of CCC ovary were CK7 (31/31) (100%), WT1 (0/50), 
      p53 (20/26, 'wild type'), ER (4/31, focal) (12.9%), PAX8 (14/14) (100%),
      glypican-3 (4/10, focal) (44.4%), p16INK4 (5/5, focal) and CK20 (0/5). Various
      IHC markers expressed in HGSCs were WT1 (48/50) (96%), p53 (31/31, mostly
      'mutation type'), CK7 (9/9) (100%) ER (13/16, variable) (81.2%) and PAX8 (14/14) 
      (100%). IHC markers expressed in EMACs were ER (15/16) (93.7%), CK7 (2/2) (100%) 
      and WT1 (0/7). IHC markers expressed in mixed carcinomas were CK7 (2/2) (100%),
      WT1 (0/2), focal Napsin A (6/6) and focal ER (5/6). The sensitivity and
      specificity of Napsin A for the diagnosis of CCC ovary was 100% and 90.9%,
      respectively. The sensitivity and specificity of WT1 for diagnosis of HGSC ovary 
      was found to be 96% and 100%, respectively. Napsin A and WT1 are highly sensitive
      and specific IHC markers for diagnosing ovarian CCCs and HGSCs, respectively, and
      in differentiating these tumours from their mimics. Napsin A is useful in
      identification of component of CCC in certain EMACs.
CI  - (c) 2017 APMIS. Published by John Wiley & Sons Ltd.
FAU - Rekhi, Bharat
AU  - Rekhi B
AD  - Department of Surgical Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
FAU - Deodhar, Kedar K
AU  - Deodhar KK
AD  - Department of Surgical Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
FAU - Menon, Santosh
AU  - Menon S
AD  - Department of Surgical Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
FAU - Maheshwari, Amita
AU  - Maheshwari A
AD  - Department of Surgical Oncology (Gynaecology), Tata Memorial Hospital, Parel,
      Mumbai, India.
FAU - Bajpai, Jyoti
AU  - Bajpai J
AD  - Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
FAU - Ghosh, Jaya
AU  - Ghosh J
AD  - Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
FAU - Shylasree, Surappa Thumkur
AU  - Shylasree ST
AD  - Department of Surgical Oncology (Gynaecology), Tata Memorial Hospital, Parel,
      Mumbai, India.
FAU - Gupta, Sudeep
AU  - Gupta S
AD  - Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
LA  - eng
PT  - Journal Article
DEP - 20171120
PL  - Denmark
TA  - APMIS
JT  - APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
JID - 8803400
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (WT1 Proteins)
RN  - 0 (WT1 protein, human)
RN  - EC 3.4.23.- (Aspartic Acid Endopeptidases)
RN  - EC 3.4.23.- (NAPSA protein, human)
RN  - Ovarian epithelial cancer
SB  - IM
MH  - Adenocarcinoma, Clear Cell/*diagnosis/pathology
MH  - Adult
MH  - Aged
MH  - Aspartic Acid Endopeptidases/*analysis
MH  - Biomarkers, Tumor
MH  - Cystadenocarcinoma, Serous/*diagnosis/pathology
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immunohistochemistry
MH  - Middle Aged
MH  - Neoplasms, Glandular and Epithelial/*diagnosis/pathology
MH  - Ovarian Neoplasms/*diagnosis/pathology
MH  - Prospective Studies
MH  - WT1 Proteins/*analysis
OTO - NOTNLM
OT  - Napsin A
OT  - WT1
OT  - clear cell carcinoma
OT  - epithelial ovarian cancers
OT  - high-grade serous carcinoma
OT  - immunohistochemistry
EDAT- 2017/12/22 06:00
MHDA- 2018/01/09 06:00
CRDT- 2017/12/22 06:00
PHST- 2017/07/20 00:00 [received]
PHST- 2017/09/18 00:00 [accepted]
PHST- 2017/12/22 06:00 [pubmed]
PHST- 2018/01/09 06:00 [medline]
PHST- 2017/12/22 06:00 [entrez]
AID - 10.1111/apm.12784 [doi]
PST - ppublish
SO  - APMIS. 2018 Jan;126(1):45-55. doi: 10.1111/apm.12784. Epub 2017 Nov 20.