【免疫組織化学】GATA3の有用性：種々の臓器で陽性を示すが、乳癌・前立腺癌に比較的特異性が高く、使い方次第で有用；（＋α）高グレード前立腺癌に注意
GATA3: a multispecific but potentially useful marker in surgical pathology: a systematic analysis of 2500 epithelial and nonepithelial tumors
Markku Miettinen, Peter A McCue, Maarit Sarlomo-Rikala, Janusz Rys, Piotr Czapiewski, Krzysztof Wazny, Renata Langfort, Piotr Waloszczyk, Wojciech Biernat, Jerzy Lasota, Zengfeng Wang
Am J Surg Pathol. 2014 Jan;38(1):13-22
GATA3 は、今や病理診断の場面で「乳癌」と「尿路上皮癌」に特異的とされがちであるが、もともと「使い方に注意すれば有用」なもので、様々な臓器・腫瘍で陽性を示すので注意が必要である。これはそのことを多大な種類の腫瘍で確認した論文である。
Abstract
GATA3 is a transcription factor important in the differentiation of breast epithelia, urothelia, and subsets of T lymphocytes. It has been suggested to be useful in the evaluation of carcinomas of mammary or urothelial origin or metastatic carcinomas, but its distribution in normal and neoplastic tissues is incompletely mapped. In this study, we examined normal developing and adult tissues and 2040 epithelial and 460 mesenchymal or neuroectodermal neoplasms for GATA3 expression to explore its diagnostic value in surgical pathology, using monoclonal antibody (clone L50-823) and Leica Bond automated immunohistochemistry. GATA3 was expressed in trophoblast, fetal and adult epidermis, adult mammary and some salivary gland and sweat gland ductal epithelia, urothelia, distal nephron in developing and adult tissues, some prostatic basal cells, and subsets of T lymphocytes. It was expressed stronger in fetal than in adult mesothelia and was absent in respiratory and gastrointestinal epithelia. In epithelial neoplasms, GATA3 was expressed in >90% of primary and metastatic ductal and lobular carcinomas of the breast, urothelial, and cutaneous basal cell carcinomas and trophoblastic and endodermal sinus tumors. In metastatic breast carcinomas, it was more sensitive than GCDFP. Among squamous cell carcinomas, the expression was highest in the skin (81%) and lower in cervical (33%), laryngeal (16%), and pulmonary tumors (12%). Common positivity was found in skin adnexal tumors (100%), mesothelioma (58%), salivary gland (43%), and pancreatic (37%) ductal carcinomas, whereas frequency of expression in adenocarcinomas of lung, stomach, colon, endometrium, ovary, and prostate was <10%. Chromophobe renal cell carcinoma was a unique renal tumor with frequent positivity (51%), whereas oncocytomas were positive in 17% of cases but other types only rarely. Among mesenchymal and neuroectodermal tumors, paragangliomas were usually positive, which sets these tumors apart from epithelial neuroendocrine tumors. Mesenchymal tumors were only sporadically positive, except epithelia of biphasic synovial sarcomas. GATA3 is a useful marker in the characterization of not only mammary and urothelial but also renal and germ cell tumors, mesotheliomas, and paragangliomas. The multiple specificities of GATA3 should be taken into account when using this marker to detect metastatic mammary or urothelial carcinomas.
【SANOTIC SUMMARY】
その後の研究の内容も含めてレビューする
１．乳癌（特に luminal）と尿路上皮癌で感度が高い
近縁の唾液腺導管癌、皮膚のアポクリン系腫瘍、下部尿路腫瘍などでも発現頻度が高い。
２．特異度にはやはり注意が必要
かなり多くの種類の臓器・腫瘍で発現がみられるので、必ず他のマーカーと組み合わせて用いるべきである。
３．高悪性度の前立腺癌では陽性頻度が高い（＋α）
実は今回これを言いたいがために過去論文をレビューした。Gleason score 8 以上の前立腺癌では意外にも GATA3 の陽性率が高い。その文献は以下。現在 ahead of print の状態なので、正式に publish されたら前立腺の項目で再度記載しようと思う。
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