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Prospective evaluation of TLE1 as a diagnostic immunohistochemical marker in synovial sarcoma Jagdis, Amanda; Rubin, Brian P.; Tubbs, Raymond R.; Pacheco, Marina; Nielsen, Torsten

Abstract

Synovial sarcoma is a high-grade soft tissue sarcoma that can be challenging to diagnose on the basis of histology alone. It is defined by a characteristic translocation t(X;18) that produces the fusion oncogene SYT-SSX. The current diagnostic gold standard for synovial sarcoma is demonstration of the translocation by fluorescence in situ hybridization, reverse transcriptase polymerase chain reaction, or cytogenetics, in an appropriate histologic context. TLE1 encodes a transcriptional corepressor that is overexpressed in synovial sarcomas. Gene and tissue microarray studies have identified TLE1 as an excellent bio-marker for distinguishing synovial sarcoma from other soft tissue malignancies. We prospectively evaluated incoming soft tissue tumor cases where the histology and clinical setting made synovial sarcoma a real consideration in the differential diagnosis. TLE1, Bcl2, EMA and cytokeratin expression were assessed using commercially available antibodies. TLE1 gave intense, diffuse nuclear staining in 35 of 35 molecularly-confirmed synovial sarcoma cases, and was rare to absent in the 73 other soft tissue tumors examined (positive staining was found in only 1 of 43 malignant peripheral nerve sheath tumors, the one tested fibrosarcoma, and 1 pleomorphic sarcoma). TLE1 was more sensitive and specific for synovial sarcoma than other currently available immunohistochemical markers including Bcl2, EMA and cytokeratins, and had a positive predictive value of 92% and a negative predictive value of 100% in this clinical setting. Our findings confirm, in a prospective diagnostic context, that TLE1 is more sensitive and specific for synovial sarcoma than any other currently available immunohistochemical stains, and in some cases may preclude the need for molecular testing.

Item Metadata

Title
Prospective evaluation of TLE1 as a diagnostic immunohistochemical marker in synovial sarcoma
Creator
Jagdis, Amanda; Rubin, Brian P.; Tubbs, Raymond R.; Pacheco, Marina; Nielsen, Torsten
Contributor
Vancouver General Hospital
Publisher
The AmericLippincott, Williams & Wilkins (United States)
Date Issued
2009-12
Description
Synovial sarcoma is a high-grade soft tissue sarcoma that can be challenging to diagnose on the basis of histology alone. It is defined by a characteristic translocation t(X;18) that produces the fusion oncogene SYT-SSX. The current diagnostic gold standard for synovial sarcoma is demonstration of the translocation by fluorescence in situ hybridization, reverse transcriptase polymerase chain reaction, or cytogenetics, in an appropriate histologic context. TLE1 encodes a transcriptional corepressor that is overexpressed in synovial sarcomas. Gene and tissue microarray studies have identified TLE1 as an excellent bio-marker for distinguishing synovial sarcoma from other soft tissue malignancies. We prospectively evaluated incoming soft tissue tumor cases where the histology and clinical setting made synovial sarcoma a real consideration in the differential diagnosis. TLE1, Bcl2, EMA and cytokeratin expression were assessed using commercially available antibodies. TLE1 gave intense, diffuse nuclear staining in 35 of 35 molecularly-confirmed synovial sarcoma cases, and was rare to absent in the 73 other soft tissue tumors examined (positive staining was found in only 1 of 43 malignant peripheral nerve sheath tumors, the one tested fibrosarcoma, and 1 pleomorphic sarcoma). TLE1 was more sensitive and specific for synovial sarcoma than other currently available immunohistochemical markers including Bcl2, EMA and cytokeratins, and had a positive predictive value of 92% and a negative predictive value of 100% in this clinical setting. Our findings confirm, in a prospective diagnostic context, that TLE1 is more sensitive and specific for synovial sarcoma than any other currently available immunohistochemical stains, and in some cases may preclude the need for molecular testing.
Subject
synovial sarcoma; TLE1; immunohistochemistry
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2021-06-22
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0398489
URI
http://hdl.handle.net/2429/78754
Affiliation
Medicine, Faculty of; Non UBC; Pathology and Laboratory Medicine, Department of
Citation
Jagdis, Amanda MD*; Rubin, Brian P. MD, PhD†; Tubbs, Raymond R. MD†; Pacheco, Marina MD*; Nielsen, Torsten O. MD, PhD, FRCPC* Prospective Evaluation of TLE1 as a Diagnostic Immunohistochemical Marker in Synovial Sarcoma, The American Journal of Surgical Pathology: December 2009 - Volume 33 - Issue 12 - p 1743-1751
Publisher DOI
10.1097/PAS.0b013e3181b7ed36
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International