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Immunhistochemische Keimstrangmarker

Beschreibung und Einsatz in der Differenzialdiagnose von Ovarialtumoren

Immunohistochemical sex cord markers

Description and use in the differential diagnosis of ovarian tumors

  • Schwerpunkt: Ovarialtumoren
  • Published:
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Zusammenfassung

Zu den Keimstrangmarkern gehören Proteine und Hormone, die in den Keimstrangderivaten normaler Ovarien und Hoden sowie in gonadalen Keimstrang-Stroma-Tumoren produziert werden. Klinisch können Keimstrangmarker (vor allem Inhibin-α) als Serumtumormarker eingesetzt werden. Der immunhistochemische Nachweis von Keimstrangmarkern ist hilfreich bei der differenzialdiagnostischen Abgrenzung ovarieller Keimstrang-Stroma-Tumoren von Oberflächenepithel-Stroma-Tumoren, Keimzelltumoren, anderen Ovarialtumoren und Ovarialmetastasen. Inhibin-α ist der spezifischste momentan verfügbare Keimstrangmarker. Calretinin gilt im Vergleich als noch etwas sensitiver bei jedoch reduzierter Spezifität. Ein Markerpanel bestehend aus Inhibin-α und Calretinin wird derzeit als optimal für die Differenzialdiagnose der ovariellen Keimstrang-Stroma-Tumoren angesehen. CD99, MIS („Müllerian inhibiting substance“, Anti-Müller-Hormon), Melan-A und CD10 sind weitere Keimstrangmarker von begrenzter Sensitivität und Spezifität. Ihr Einsatz sollte in der Diagnostik von Ovarialtumoren nur gezielt und als Teil eines Markerpanels erfolgen. Als sinnvolle mögliche Ergänzung eines immunhistochemischen Markerpanels in der Differenzialdiagnose ovarieller Keimstrang-Stroma-Tumoren gelten EMA, CK7 und Chromogranin.

Abstract

Sex cord markers comprise proteins and hormones that are produced in sex cord-derivatives in normal ovaries and testes as well as in gonadal sex cord-stromal tumors. Sex cord markers (e.g. inhibin-α) are used clinically as serum tumor markers. Immunohistochemical staining of sex cord markers may be helpful in the differential diagnosis of ovarian sex cord-stromal tumors versus surface epithelial-stromal tumors, germ cell tumors, other ovarian tumors, and ovarian metastases. Inhibin-α has been shown to be the most specific marker of sex cord differentiation. In comparison, calretinin is a somewhat more sensitive albeit less specific marker. Currently, an immunohistochemical panel including inhibin-α and calretinin is considered most helpful in the differential diagnosis of ovarian sex cord-stromal tumors. CD99, Müllerian inhibiting substance (MIS), melan A and CD10, being sex cord markers of limited sensitivity and specificity, should only be used as part of an antibody panel in specific diagnostic settings. EMA, CK7 and chromogranin are considered additional markers that may be useful in the differential diagnosis of ovarian sex cord-stromal tumors.

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  1. Institut für Pathologie, Referenzzentrum für Gynäkopathologie, A2/2, 68159, Mannheim, Deutschland

    F. Kommoss & D. Schmidt

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  2. D. Schmidt
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Correspondence to F. Kommoss.

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Kommoss, F., Schmidt, D. Immunhistochemische Keimstrangmarker. Pathologe 28, 187–194 (2007). https://doi.org/10.1007/s00292-007-0911-0

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  • DOI: https://doi.org/10.1007/s00292-007-0911-0

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