ORIGINAL ARTICLE

Friend leukaemia integration-1 expression in malignant and benign tumours: a multiple tumour tissue microarray analysis using polyclonal antibody

Paulette Mhawech-Fauceglia¹, Francois R Herrmann², Wiam Bshara¹, Kunle Odunsi¹, Luigi Terracciano³, Guido Sauter⁴, Richard T Cheney¹, Jeff Groth¹, Remedios Penetrante¹, Paulette Mhawech-Fauceglia¹

¹ Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
² Department of Rehabilitation and Geriatrics at Geneva University Hospitals, Geneva, Switzerland
³ Institute of Pathology, Basel University Hospital, Basel, Switzerland
⁴ Department of Pathology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany

Correspondence to:
Dr P Mhawech-Fauceglia
Department of Pathology, Oswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA; pmhawech1{at}yahoo.com

Background: Friend leukaemia integration-1 (FLI-1) antibody is a useful marker for Ewing’s sarcoma/primitive neuroectodermal tumour (EWS/PNET) and vascular tumours. However, it is also expressed in subsets of lymphoblastic lymphoma, Merkel cell carcinoma (MCC) and desmoplastic small round cell tumour (DSRCT).

Aim: To determine expression of FLI-1 in various benign and malignant neoplasms, by immunohistochemical analysis on 4323 tumours using multiple tumour microarrays, as well as on whole sections.

Results: FLI-1 was expressed in 46/62 EWS/PNETs, 2/3 olfactory neuroblastomas, 7/102 small cell carcinomas of the lung, 10/34 MCCs, 1/14 rhabdomyosarcoma, 19/132 non-Hodgkin’s lymphomas, 2/3 DSRCTs, and in 53/74 benign and malignant vascular tumours. In addition, 27/508 squamous cell carcinomas, 19/837 adenocarcinomas, 10/400 urothelial bladder cancers, 1/40 basal cell carcinomas, 3/29 liposarcomas, 1/40 glioblastoma multiforme and 9/29 medullar carcinomas of the breast expressed FLI-1. The sensitivity and specificity of FLI-1 to distinguish EWS/PNET from all types of malignancies were 74.2% and 96.0%, respectively. Finally, the sensitivity and specificity of FLI-1 to distinguish EWS/PNET from other small round cell tumours (SRCTs) were 74.2% and 91.6%, respectively.

Conclusion: This study was the first to show that FLI-1 can be seen in a variety of solid tumours, some of which had never been explored before. This finding should be kept in mind, especially when using FLI-1 as a marker for finding the primary origin of poorly differentiated metastatic tumour. Finally, despite the expression of FLI-1 in numerous malignancies, it is still considered to be highly sensitive and specific in distinguishing EWS/PNET from other tumour types in general and from other SRCTs in particular.

Abbreviations: DSRCT, desmoplastic small round cell tumour; EWS/PNET, Ewing’s sarcoma/primitive neuroectodermal tumour; FLI-1, friend leukaemia integration-1; MCC, Merkel cell carcinoma; NHL, non-Hodgkin’s lymphoma; ONB, olfactory neuroblastoma; RMS, rhabdomyosarcoma; SRCT, small round cell tumour

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