EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma
Thymic carcinoma is an aggressive malignancy that can be challenging to distinguish from thymoma using histomorphology. We assessed two emerging markers for these entities, EZH2 and POU2F3, and compared them with conventional immunostains. Whole slide sections of 37 thymic carcinomas, 23 type A thym...
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MDPI AG
2023-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/8/2274 |
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| author | Julia R. Naso Julie A. Vrana Justin W. Koepplin Julian R. Molina Anja C. Roden |
| author_facet | Julia R. Naso Julie A. Vrana Justin W. Koepplin Julian R. Molina Anja C. Roden |
| author_sort | Julia R. Naso |
| collection | DOAJ |
| description | Thymic carcinoma is an aggressive malignancy that can be challenging to distinguish from thymoma using histomorphology. We assessed two emerging markers for these entities, EZH2 and POU2F3, and compared them with conventional immunostains. Whole slide sections of 37 thymic carcinomas, 23 type A thymomas, 13 type B3 thymomas, and 8 micronodular thymomas with lymphoid stroma (MNTLS) were immunostained for EZH2, POU2F3, CD117, CD5, TdT, BAP1, and MTAP. POU2F3 (≥10% hotspot staining), CD117, and CD5 showed 100% specificity for thymic carcinoma versus thymoma with 51%, 86%, and 35% sensitivity, respectively, for thymic carcinoma. All POU2F3 positive cases were also positive for CD117. All thymic carcinomas showed >10% EZH2 staining. EZH2 (≥80% staining) had a sensitivity of 81% for thymic carcinoma and a specificity of 100% for thymic carcinoma versus type A thymoma and MNTLS but had poor specificity (46%) for thymic carcinoma versus B3 thymoma. Adding EZH2 to a panel of CD117, TdT, BAP1, and MTAP increased cases with informative results from 67/81 (83%) to 77/81 (95%). Overall, absent EZH2 staining may be useful for excluding thymic carcinoma, diffuse EZH2 staining may help to exclude type A thymoma and MNTLS, and ≥10% POU2F3 staining has excellent specificity for thymic carcinoma versus thymoma. |
| first_indexed | 2024-03-11T05:09:44Z |
| format | Article |
| id | doaj.art-128e493e8b0b402ba33931f3c804f412 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:09:44Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-128e493e8b0b402ba33931f3c804f4122023-11-17T18:38:43ZengMDPI AGCancers2072-66942023-04-01158227410.3390/cancers15082274EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from ThymomaJulia R. Naso0Julie A. Vrana1Justin W. Koepplin2Julian R. Molina3Anja C. Roden4Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USADepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USADepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USADivision of Medical Oncology, Mayo Clinic, Rochester, MN 55902, USADepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USAThymic carcinoma is an aggressive malignancy that can be challenging to distinguish from thymoma using histomorphology. We assessed two emerging markers for these entities, EZH2 and POU2F3, and compared them with conventional immunostains. Whole slide sections of 37 thymic carcinomas, 23 type A thymomas, 13 type B3 thymomas, and 8 micronodular thymomas with lymphoid stroma (MNTLS) were immunostained for EZH2, POU2F3, CD117, CD5, TdT, BAP1, and MTAP. POU2F3 (≥10% hotspot staining), CD117, and CD5 showed 100% specificity for thymic carcinoma versus thymoma with 51%, 86%, and 35% sensitivity, respectively, for thymic carcinoma. All POU2F3 positive cases were also positive for CD117. All thymic carcinomas showed >10% EZH2 staining. EZH2 (≥80% staining) had a sensitivity of 81% for thymic carcinoma and a specificity of 100% for thymic carcinoma versus type A thymoma and MNTLS but had poor specificity (46%) for thymic carcinoma versus B3 thymoma. Adding EZH2 to a panel of CD117, TdT, BAP1, and MTAP increased cases with informative results from 67/81 (83%) to 77/81 (95%). Overall, absent EZH2 staining may be useful for excluding thymic carcinoma, diffuse EZH2 staining may help to exclude type A thymoma and MNTLS, and ≥10% POU2F3 staining has excellent specificity for thymic carcinoma versus thymoma.https://www.mdpi.com/2072-6694/15/8/2274thymic carcinomathymomaimmunohistochemistryEZH2POU2F3 |
| spellingShingle | Julia R. Naso Julie A. Vrana Justin W. Koepplin Julian R. Molina Anja C. Roden EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma Cancers thymic carcinoma thymoma immunohistochemistry EZH2 POU2F3 |
| title | EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma |
| title_full | EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma |
| title_fullStr | EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma |
| title_full_unstemmed | EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma |
| title_short | EZH2 and POU2F3 Can Aid in the Distinction of Thymic Carcinoma from Thymoma |
| title_sort | ezh2 and pou2f3 can aid in the distinction of thymic carcinoma from thymoma |
| topic | thymic carcinoma thymoma immunohistochemistry EZH2 POU2F3 |
| url | https://www.mdpi.com/2072-6694/15/8/2274 |
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