肉瘤样/促纤维增生性间皮瘤与肺肉瘤样癌胸膜转移的鉴别诊断较为困难，两者形态学类似且常仅表达广谱细胞角蛋白。GATA结合蛋白3（GATA binding protein 3,GATA3）免疫组化标记主要表达在乳腺癌及尿路上皮癌， 但也可表达于其他类型肿瘤，如间皮瘤。本研究中，我们探究了GATA3免疫组化染色是否可用于鉴别肉瘤样/ 促纤维增生性间皮瘤（N=19）与肺肉瘤样癌（N=13）。免疫组化染色结果根据染色强度及范围进行评分，最高分值为6分。所有19例肉瘤样/促纤维增生性间皮瘤均为弥漫强阳性染色（无病例低于3分，19例平均值±标准差5.4±0.9），而13例肺肉瘤样癌中仅有2例GATA3染色阳性，且仅为灶状弱阳性（两例评分均为2分，13例平均值±标准差0.4±0.8）。此外，GATA3染色阳性强度及范围与传统间皮瘤标记间无明确相关性。综上，任何程度的GATA3阳性染色在肉瘤样/促纤维增生性间皮瘤中表达的敏感性为100%，特异性为85%。因此，我们认为，GATA3弥漫强阳性染色支持肉瘤样/促纤维增生性间皮瘤而非肺肉瘤样癌。反之，GATA3表达完全缺失则是不支持诊断为肉瘤样/ 促纤维增生性间皮瘤的有力依据。

　　来源：Am J Surg Pathol 2017;41:1221–1225

　　美国外科病理学杂志中文版2017年第一期摘要No.7

　　（李媛 翻译/审校）
 

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