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PAX8 expression in anaplastic thyroid carcinoma is less than those reported in early studies: a multi-institutional study of 182 cases using the monoclonal antibody MRQ-50

  • Wei-An Lai
  • Jen-Fan HangEmail author
  • Chih-Yi Liu
  • Yanhua Bai
  • Zhiyan Liu
  • Haiyan Gu
  • SoonWon Hong
  • Ju Yeon Pyo
  • Chan Kwon Jung
  • Kennichi Kakudo
  • Andrey Bychkov
Original Article
  • 39 Downloads

Abstract

Anaplastic thyroid carcinoma (ATC) is an aggressive malignant tumor composed of undifferentiated thyroid follicular cells. Pathological diagnosis of ATC can be challenging as the tumor may show morphological overlap with other neoplasms with anaplastic morphology. Immunohistochemical demonstration of thyroid origin facilitates the diagnosis of ATC. Previous studies using the polyclonal anti-PAX8 antibody 10336-1-AP suggested that PAX8 was the most sensitive marker, expressed in up to 80% of ATC. According to a 2018 NordiQC report, the monoclonal anti-PAX8 antibody MRQ-50 has become the most commonly used anti-PAX8 antibody worldwide. However, validation of this antibody in ATC is lacking. In this study, we recruited 182 ATC cases from seven institutions. Pathology slides were subjected to histology review. PAX8 immunohistochemistry using the MRQ-50 antibody was performed in whole tissue slides (n = 147) or tissue microarray sections (n = 35). We found PAX8 expression in 54.4% of the cases, which was significantly lower than those reported in prior studies with the polyclonal antibody. PAX8 expression was positively correlated with the presence of an epithelial pattern (63.6% vs 37.5%, p = 0.0008) and a coexisting differentiated thyroid carcinoma component (71.6% vs 44.3%, p = 0.0004), but was not associated with age, gender, specimen type, or presence of giant cell and sarcomatoid patterns. In conclusion, we demonstrated PAX8 expression using the monoclonal antibody MRQ-50 in only half of the cases in a large ATC series. Pathologists should be aware that PAX8 expression in ATC is less than those reported in early studies to avoid misdiagnosis.

Keywords

Paired box gene 8 (PAX8) Anaplastic thyroid carcinoma (ATC) Undifferentiated thyroid carcinoma Immunohistochemistry MRQ-50 

Notes

Contributions

A. Bychkov and J. Hang designed the study. W. Lai, J. Hang, C. Liu, Y. Bai, Z. Liu, H. Gu, S. Hong, J. Pyo, C. Jung, and A. Bychkov reviewed the slides and collected the data. W. Lai and J. Hang analyzed the data and performed the study. W. Lai, J. Hang, and A. Bychkov wrote the paper. K. Kakudo supervised the study and provided critical revision.

Funding information

This study was supported by the research grant from Taipei Veterans General Hospital, Taipei, Taiwan (Grant No.: V108B-011).

Compliance with ethical standards

This study was approved by the institutional review boards of the participating centers.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Wei-An Lai
    • 1
  • Jen-Fan Hang
    • 1
    • 2
    Email author
  • Chih-Yi Liu
    • 3
  • Yanhua Bai
    • 4
  • Zhiyan Liu
    • 5
    • 6
  • Haiyan Gu
    • 7
  • SoonWon Hong
    • 8
  • Ju Yeon Pyo
    • 8
  • Chan Kwon Jung
    • 9
  • Kennichi Kakudo
    • 10
  • Andrey Bychkov
    • 11
    • 12
    • 13
  1. 1.Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Division of PathologySijhih Cathay General HospitalNew Taipei CityTaiwan
  4. 4.Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of PathologyPeking University Cancer Hospital & InstituteBeijingChina
  5. 5.Department of Pathology, School of Basic Medical SciencesShandong UniversityJinanChina
  6. 6.Department of Pathology, Qilu HospitalShandong UniversityJinanChina
  7. 7.Department of PathologyThe Affiliated Hospital of Qingdao UniversityQingdaoChina
  8. 8.Department of Pathology, College of Medicine, Gangnam Severance HospitalYonsei UniversitySeoulKorea
  9. 9.Department of Hospital Pathology, College of MedicineThe Catholic University of KoreaSeoulKorea
  10. 10.Department of Pathology, Nara Hospital, Faculty of MedicineKindai UniversityNaraJapan
  11. 11.Department of Pathology, Faculty of MedicineChulalongkorn UniversityBangkokThailand
  12. 12.Department of PathologyKameda Medical CenterKamogawaJapan
  13. 13.Department of Pathology, Graduate School of Biomedical SciencesNagasaki UniversityNagasakiJapan

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