INSM1在胃肠胰神经内分泌肿瘤诊断中的价值

目的探讨胰岛素瘤相关蛋白1(insulinoma-associated protein 1,INSM1)在胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasms,GEP-NEN)中的表达及其在诊断中的应用价值。方法应用免疫组化En Vision法检测48例GEPNEN和40例胃肠胰非神经内分泌肿瘤中INSM1、Cg A、Syn和CD56的表达,并分析其与GEP-NEN临床病理特征的关系。结果48例GEP-NEN中,INSM1的阳性率为81. 3%,而Cg A、Syn和CD56的阳性率分别为50%(24/48)、89. 9%(43/48)和66. 7%(32/48),INSM1、Cg A、Syn和CD56在胃肠胰非神经内分泌瘤中的阳性率分别为0 (0/40)、10. 0%(4/40)、12. 5%(5/40)和10%(4/40),INSM1、Cg A、Syn和CD56在GEP-NEN中的表达均明显高于胃肠胰非神经内分泌瘤中的表达(P <0. 05);INSM1主要表达于食管、胰腺和结直肠神经内分泌肿瘤中,与Cg A、Syn和CD56表达不同,INSM1表达与GEP-NEN分级无关(P> 0. 05)。INSM1对GEP-NEN诊断的灵敏度高于Cg A,特异度与Cg A、Syn和CD56差异无统计学意义(P> 0. 05)。结论INSM1属于新的神经内分泌标志物,可与Cg A、Syn和CD56联合检测用于GEP-NEN的诊断。

Diagnostic value of INSM1 in gastroenteropancreatic neuroendocrine neoplasms

Purpose To investigate the expression of insulinoma-associated protein 1 (INSM1) in gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) and its value of INSM1 in the diagnosis of GEP-NEN. Methods The expression of INSM1,CgA,Syn and CD56 in 48 cases of GEP-NEN and 40 cases of non GEP-NEN was detected by EnVision immunohistochemical staining,and the correlation between INSM1 expression and clinicopathologic features was also analyzed. Results Of 48 cases of GEP-NEN,the positive rate of INSM1 was 81.3%,while the positive rates of CgA,Syn and CD56 were 50%(24/48),89.9%(43/48) and 66.7%(32/48),respectively. The positive rates of INSM1,CgA,Syn and CD56 in GEP-NEN were 0 (0/40),10%(4/40),12.5%(5/40) and 10%(4/40),respectively. The expression of INSM1,CgA,Syn and CD56 in GEP-NEN was significantly higher than that in non GEP-NEN ( P <0.05). Compared with CgA,Syn and CD56,INSM1 was mainly expressed in esophageal,pancreatic and colorectal neuroendocrine tumors. INSM1 expression was unrelated to the grading of GEP-NEN ( P >0.05). The sensitivity of INSM1 in the diagnosis of GEP-NEN was higher than that of CgA,but the specificity of was not significantly different from that of CgA,Syn and CD56 ( P >0.05). Conclusion INSM1 is a new neuroendocrine marker that can be used in the diagnosis of gastrointestinal and pancreatic neuroendocrine tumors by combined detection of CgA,Syn and CD56.