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  • Title: [Expression of GPNMB in renal eosinophilic tumors and its value in differential diagnosis].
    Author: Wang Y, Hou MY, Fu Y, Meng K, Wu HY, Chen J, Xu YM, Shi J, Fan XS.
    Journal: Zhonghua Bing Li Xue Za Zhi; 2023 Apr 08; 52(4):358-363. PubMed ID: 36973196.
    Abstract:
    Objective: To investigate the expression of glycoprotein non metastatic melanoma protein B (GPNMB) in renal eosinophilic tumors and to compare the value of GPNMB with CK20, CK7 and CD117 in the differential diagnosis of renal eosinophilic tumors. Methods: Traditional renal tumor eosinophil subtypes, including 22 cases of renal clear cell carcinoma eosinophil subtype (e-ccRCC), 19 cases of renal papillary cell carcinoma eosinophil subtype (e-papRCC), 17 cases of renal chromophobe cell carcinoma eosinophil subtype (e-chRCC), 12 cases of renal oncocytoma (RO) and emerging renal tumor types with eosinophil characteristics [3 cases of eosinophilic solid cystic renal cell carcinoma (ESC RCC), 3 cases of renal low-grade eosinophil tumor (LOT), 4 cases of fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and 5 cases of renal epithelioid angiomyolipoma (E-AML)], were collected at the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2017 to March 2022. The expression of GPNMB, CK20, CK7 and CD117 was detected by immunohistochemistry and statistically analyzed. Results: GPNMB was expressed in all emerging renal tumor types with eosinophil characteristics (ESC RCC, LOT, FH-dRCC) and E-AML, while the expression rates in traditional renal eosinophil subtypes e-papRCC, e-chRCC, e-ccRCC and RO were very low or zero (1/19, 1/17, 0/22 and 0/12, respectively); the expression rate of CK7 in LOT (3/3), e-chRCC (15/17), e-ccRCC (4/22), e-papRCC (2/19), ESC RCC (0/3), RO (4/12), E-AML(1/5), and FH-dRCC (2/4) variedly; the expression of CK20 was different in ESC RCC (3/3), LOT(3/3), e-chRCC(1/17), RO(9/12), e-papRCC(4/19), FH-dRCC(1/4), e-ccRCC(0/22) and E-AML(0/5), and so did that of CD117 in e-ccRCC(2/22), e-papRCC(1/19), e-chRCC(16/17), RO(10/12), ESC RCC(0/3), LOT(1/3), E-AML(2/5) and FH-dRCC(1/4). GPNMB had 100% sensitivity and 97.1% specificity in distinguishing E-AML and emerging renal tumor types (such as ESC RCC, LOT, FH-dRCC) from traditional renal tumor types (such as e-ccRCC, e-papRCC, e-chRCC, RO),respectively. Compared with CK7, CK20 and CD117 antibodies, GPNMB was more effective in the differential diagnosis (P<0.05). Conclusion: As a new renal tumor marker, GPNMB can effectively distinguish E-AML and emerging renal tumor types with eosinophil characteristics such as ESC RCC, LOT, FH-dRCC from traditional renal tumor eosinophil subtypes such as e-ccRCC, e-papRCC, e-chRCC and RO, which is helpful for the differential diagnosis of renal eosinophilic tumors. 目的: 探讨糖蛋白非转移性黑色素瘤蛋白B(glycoprotein nonmetastatic melanoma protein B,GPNMB)在各种肾嗜酸性肿瘤中的表达情况,并比较GPNMB与细胞角蛋白(CK)20、CK7、CD117在肾嗜酸性肿瘤鉴别诊断中的价值。 方法: 收集南京大学医学院附属鼓楼医院病理科2017年1月至2022年3月传统类型肾肿瘤嗜酸细胞亚型,包括22例肾透明细胞癌嗜酸细胞亚型(e-ccRCC)、19例肾乳头状细胞癌嗜酸细胞亚型(e-papRCC)、17例肾嫌色细胞癌嗜酸细胞亚型(e-chRCC)、12例肾嗜酸细胞瘤(RO)和新兴的具有嗜酸细胞特征的肾肿瘤类型,包括3例嗜酸性实性囊性肾细胞癌(ESC RCC)、3例肾低级别嗜酸细胞肿瘤(LOT)、4例延胡索酸水合酶缺陷型肾细胞癌(FH-dRCC)以及5例肾脏上皮样血管平滑肌脂肪瘤(E-AML),采用免疫组织化学EnVision法染色检测GPNMB与CK20、CK7、CD117在上述肿瘤中的表达情况,并统计分析其在以上各种肾肿瘤鉴别诊断中的意义。 结果: GPNMB在ESC RCC、LOT、FH-dRCC这3种新兴肾肿瘤类型以及E-AML中均呈阳性表达,而在传统型肾肿瘤嗜酸细胞亚型e-papRCC、e-chRCC、e-ccRCC和RO中的表达率极低或不表达,表达比例分别为1/19、1/17、0/22和0/12;CK7在LOT(3/3)、e-chRCC(15/17)、e-ccRCC(4/22)、e-papRCC(2/19)、ESC RCC(0/3)、RO(4/12)、E-AML(1/5)、FH-dRCC(2/4)中的表达比例多少不等;CK20在ESC RCC(3/3)、LOT(3/3)、e-chRCC(1/17)、RO(9/12)、e-papRCC(4/19)、FH-dRCC(1/4)、e-ccRCC(0/22)、E-AML(0/5)中的表达情况差异也较大;CD117在e-ccRCC(2/22)、e-papRCC(1/19)、e-chRCC(16/17)、RO(10/12)、ESC RCC(0/3)、LOT(1/3)、E-AML(2/5)、FH-dRCC(1/4)中的表达比例也明显不同。GPNMB在鉴别E-AML和新兴的具有嗜酸细胞特征的肾肿瘤类型(如ESC RCC、LOT、FH-dRCC)与传统类型肾肿瘤类型嗜酸细胞亚型(如e-ccRCC、e-papRCC、e-chRCC和RO)灵敏度、特异度分别为100%、97.1%,并且与CK7、CK20、CD117抗体相比,GPNMB在鉴别E-AML和新兴类型的具有嗜酸细胞特征的肾肿瘤与传统类型肾肿瘤的嗜酸细胞亚型方面更具有优势(P<0.05)。 结论: GPNMB作为一种新的肾肿瘤标志物,可以有效地将E-AML和新兴的具有嗜酸细胞特征的肾肿瘤类型如ESC RCC、LOT、FH-dRCC从传统型肾肿瘤嗜酸细胞亚型如e-ccRCC、e-papRCC、e-chRCC和RO中区分开来,有助于肾脏嗜酸性肿瘤的鉴别诊断。.
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