TY - JOUR
T1 - Diagnostic utility of SALL4 in primary germ cell tumors of the central nervous system
T2 - A study of 77 cases
AU - Mei, Kaiyong
AU - Liu, Aijun
AU - Allan, Robert W.
AU - Wang, Peng
AU - Lane, Zhaoli
AU - Abel, Ty W.
AU - Wei, Lixin
AU - Cheng, Hong
AU - Guo, Shuangping
AU - Peng, Yan
AU - Rakheja, Dinesh
AU - Wang, Min
AU - Ma, Joe
AU - Rodriguez, Maria M.
AU - Li, Jianping
AU - Cao, Dengfeng
PY - 2009/12
Y1 - 2009/12
N2 - Primary germ cell tumors of the central nervous system (CNS) sometimes pose diagnostic difficulty. In this study we analyzed the diagnostic utility of a novel marker, SALL4, in 77 such tumors (59 pure and 18 mixed) consisting of the following tumors/tumor components: 49 germinomas, 7 embryonal carcinomas, 27 yolk sac tumors, 3 choriocarcinomas, and 14 teratomas. We also stained SALL4 in 99 primary non-germ cell tumors to test SALL4 specificity. We compared SALL4 with OCT4 in all germ cell tumors and compared SALL4 with α-fetoprotein and glypican-3 in all yolk sac tumors. The staining was semiquantitatively scored as 0 (no staining), 1 (30%), 2(31-60%), 3 (61-90%), and 4 (90%). Strong SALL4 staining was observed in all 49 germinomas (4 in 48, 3 in 1), 7 embryonal carcinomas (all 4), and 27 yolk sac tumors (1 in 1, 2 in 2, 3 in 7, 4 in 17). SALL4 staining, 1 weak to focally strong, was observed in 2 of 3 choriocarcinomas (in mononucleated trophoblasts) and in 9 of 14 teratomas (in primitive neuroepithelium and teratomatous glands). All germinomas and embryonal carcinomas showed strong OCT4 staining (4 in all except 1 germinoma with 3), whereas other germ cell tumors were negative. Out of 27 yolk sac tumors, 26 showed positive α-fetoprotein staining (1 in 9, 2 in 7, 3 in 5, and 4 in 5). All yolk sac tumors showed positive glypican-3 staining (1 in 6, 2 in 6, 3 in 7, and 4 in 8). The mean percentage of yolk sac tumor cells stained was 84% with SALL4, 45% with α-fetoprotein, and 63% with glypican-3 (P0.01). No non-germ cell tumors showed SALL4 staining. Our results indicate that SALL4 is a novel sensitive diagnostic marker for primary germ cell tumors of the CNS with high specificity. SALL4 is a more sensitive marker than α-fetoprotein and glypican-3 for yolk sac tumors.
AB - Primary germ cell tumors of the central nervous system (CNS) sometimes pose diagnostic difficulty. In this study we analyzed the diagnostic utility of a novel marker, SALL4, in 77 such tumors (59 pure and 18 mixed) consisting of the following tumors/tumor components: 49 germinomas, 7 embryonal carcinomas, 27 yolk sac tumors, 3 choriocarcinomas, and 14 teratomas. We also stained SALL4 in 99 primary non-germ cell tumors to test SALL4 specificity. We compared SALL4 with OCT4 in all germ cell tumors and compared SALL4 with α-fetoprotein and glypican-3 in all yolk sac tumors. The staining was semiquantitatively scored as 0 (no staining), 1 (30%), 2(31-60%), 3 (61-90%), and 4 (90%). Strong SALL4 staining was observed in all 49 germinomas (4 in 48, 3 in 1), 7 embryonal carcinomas (all 4), and 27 yolk sac tumors (1 in 1, 2 in 2, 3 in 7, 4 in 17). SALL4 staining, 1 weak to focally strong, was observed in 2 of 3 choriocarcinomas (in mononucleated trophoblasts) and in 9 of 14 teratomas (in primitive neuroepithelium and teratomatous glands). All germinomas and embryonal carcinomas showed strong OCT4 staining (4 in all except 1 germinoma with 3), whereas other germ cell tumors were negative. Out of 27 yolk sac tumors, 26 showed positive α-fetoprotein staining (1 in 9, 2 in 7, 3 in 5, and 4 in 5). All yolk sac tumors showed positive glypican-3 staining (1 in 6, 2 in 6, 3 in 7, and 4 in 8). The mean percentage of yolk sac tumor cells stained was 84% with SALL4, 45% with α-fetoprotein, and 63% with glypican-3 (P0.01). No non-germ cell tumors showed SALL4 staining. Our results indicate that SALL4 is a novel sensitive diagnostic marker for primary germ cell tumors of the CNS with high specificity. SALL4 is a more sensitive marker than α-fetoprotein and glypican-3 for yolk sac tumors.
KW - Central nervous system
KW - Diagnostic marker
KW - Germ cell tumors
KW - SALL4
UR - http://www.scopus.com/inward/record.url?scp=71149088322&partnerID=8YFLogxK
U2 - 10.1038/modpathol.2009.148
DO - 10.1038/modpathol.2009.148
M3 - Article
C2 - 19820689
AN - SCOPUS:71149088322
SN - 0893-3952
VL - 22
SP - 1628
EP - 1636
JO - Modern Pathology
JF - Modern Pathology
IS - 12
ER -