NR4A3和Pan-TRK免疫组化染色在涎腺腺泡细胞癌与分泌性癌鉴别诊断中的应用

目的:探讨NR4A3、Pan-TRK免疫组化染色在涎腺腺泡细胞癌（acinic cell carcinoma，AciCC）、分泌性癌(secretory carcinoma of salivary gland，SCSG)鉴别诊断中的应用价值。方法:收集2010年03月至2021年01月我院病理科存档的22例AciCC、13例SCSG及132例其它涎腺肿瘤，分别进行NR4A3、Pan-TRK免疫组化染色并分析表达情况。结果:NR4A3免疫组化染色显示AciCC（21/22）阳性，其中17例局灶/弥漫强阳，4例中等阳性，1例阴性。13例SCSG及其它132例涎腺肿瘤均（-）。Pan-TRK免疫组化显示13例SCSG均（+）、22例AciCC均（-）。NR4A3在AciCC中敏感性为95.5%，特异性为100%。结论:NR4A3是AciCC一种新标记物，特别与SCSG的鉴别诊断中，联合使用Pan-TRK，可进一步提高诊断的特异性。

Application of NR4A3 and Pan-TRK immunohistochemical staining in differential diagnosis of acinic cell carcinoma and secretory carcinoma of salivary gland

Objective:To investigate the value of NR4A3 and Pan-TRK immunohistochemical staining in differential diagnosis of acinic cell carcinoma(AciCC) and secretory carcinoma of salivary gland(SCSG).Methods:The tumors were collected from March 2010 to January 2021 at our hospital,including 22 acinic cell carcinomas,13 salivary gland secretory carcinomas and 132 other salivary gland tumors.NR4A3 and Pan-TRK immunohistochemistry were attempted for all cases.Results:AciCC(21/22) expressed NR4A3 by IHC,among which 17 cases were focal/diffuse strong,4 cases were moderate and 1 case was negative.None of the SCSGs or other salivary gland tumors displayed any nuclear NR4A3 immunostaining.Pan-TRK immunohistochemistry showed that SCSGs(13/13) were positive and AciCCs(22/22) were negative.NR4A3 IHC had 95.5% sensitivity and 100% specificity for AciCC.Conclusion:NR4A3 is a new marker of AciCC，which may be particularly valuable in the differential diagnostic spectrum of AciCC and SCSG.