Synaptophysin, CD117, and GATA3 as a Diagnostic Immunohistochemical Panel for Small Cell Neuroendocrine Carcinoma of the Urinary Tract

Abstract

Although SCNEC is based on its characteristic histology, immunohistochemistry (IHC) is commonly employed to confirm neuroendocrine differentiation (NED). The challenge here is that SCNEC may yield negative results for traditional neuroendocrine markers. To establish an IHC panel for NED, 17 neuronal, basal, and luminal markers were examined on a tissue microarray construct generated from 47 cases of 34 patients with SCNEC as a discovery cohort. A decision tree algorithm was employed to analyze the extent and intensity of immunoreactivity and to develop a diagnostic model. An external cohort of eight cases and transmission electron microscopy (TEM) were used to validate the model. Among the 17 markers, the decision tree diagnostic model selected 3 markers to classify NED with 98.4% accuracy in classification. The extent of synaptophysin (>5%) was selected as the initial parameter, the extent of CD117 (>20%) as the second, and then the intensity of GATA3 (≤1.5, negative or weak immunoreactivity) as the third for NED. The importance of each variable was 0.758, 0.213, and 0.029, respectively. The model was validated by the TEM and using the external cohort. The decision tree model using synaptophysin, CD117, and GATA3 may help confirm NED of traditional marker-negative SCNEC.

Unlocking Precise Lung Cancer Detection Through Minimal Panel Immunostaining in Small Biopsy Samples

“…Synaptophysin, an integral membrane glycoprotein, is seen in presynaptic neurosecretory vesicles. This is utilized for recognizing lung tumors that exhibit neuroendocrine differentiation [17,18].…”

“…NSCLC had the highest number of reported instances, with 31 cases of adenocarcinoma and 27 cases of squamous cell carcinoma, while six cases were small cell carcinoma. We identified different patterns in adenocarcinoma comprising acinar (7), solid with mucin production (3), lipidic pattern (2), papillary pattern (1), and mixed pattern (18), as shown in Table 2.…”

Molekulare Subklassifizierung des muskelinvasiven Urothelkarzinoms der Harnblase mittels Proteinexpression von CK5/6, CK20, GATA3, p53 und Synaptophysin

“…17). Jedoch wurde in anderen Studien berichtet, dass nicht alle Tumoren mit neuroendokrinen Anteilen durch Synaptophysin angefärbt werden können 137. Um neuroendokrine Differenzierungen zuverlässig bestimmen zu können, wird die Anwendung mehrerer neuroendokriner Marker wie z.B.…”