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KMID : 0357920130470040355
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Korean Journal of Pathology
2013 Volume.47 No. 4 p.355 ~ p.364
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ERG Immunohistochemistry as an Endothelial Marker for Assessing Lymphovascular Invasion
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Kim Se-Hun
Park Hyung-Kyu
Jung Ho-Young
Lee So-Young
Min Kyueng-Whan
Kim Wook-Youn
Han Hye-Seung
Kim Wan-Seop
Hwang Tae-Sook
Lim So-Dug
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Abstract
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Background: ERG, a member of the ETS family of transcription factors, is a highly specific endothelial marker. We investigated whether the use of ERG immunostaining can help pathologists detect lymphovascular invasion (LVI) and decrease interobserver variability in LVI diagnosis. Methods: Fifteen cases of surgically resected colorectal cancers with hepatic metastasis were selected and the most representative sections for LVI detection were immunostained with ERG, CD31, and D2-40. Eight pathologists independently evaluated LVI status on hematoxylin and eosin (H&E) and the corresponding immunostained sections and then convened for a consensus meeting. The results were analyzed by kappa (κ) statistics. Results: The average rate of LVI positivity was observed in 43% with H&E only, 10% with CD31, 29% with D2-40, and 16% with ERG. Agreement among pathologists was fair for H&E only (κ=0.27), D2-40 (κ=0.21), ERG (κ=0.23), and was moderate for CD31 (κ=0.55). Consensus revealed that ERG nuclear immunoreactivity showed better visual contrast of LVI detection than the other staining, with improved agreement and LVI detection rate (κ=0.65, LVI positivity rate 80%). Conclusions: The present study demonstrated a superiority with ERG immunostaining and indicated that ERG is a promising panendothelial marker that might help pathologists increase LVI detection and decrease interobserver variability in LVI diagnosis.
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KEYWORD
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Lymphovascular invasion, Endothelial marker, Immunohistochemistry, ERG, CD31
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