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Friend leukaemia integration-1 expression in malignant and benign tumours: a multiple tumour tissue microarray analysis using polyclonal antibody
  1. Paulette Mhawech-Fauceglia1,
  2. Francois R Herrmann2,
  3. Wiam Bshara1,
  4. Kunle Odunsi1,
  5. Luigi Terracciano3,
  6. Guido Sauter4,
  7. Richard T Cheney1,
  8. Jeff Groth1,
  9. Remedios Penetrante1,
  10. Paulette Mhawech-Fauceglia1
  1. 1Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA
  2. 2Department of Rehabilitation and Geriatrics at Geneva University Hospitals, Geneva, Switzerland
  3. 3Institute of Pathology, Basel University Hospital, Basel, Switzerland
  4. 4Department of Pathology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany
  1. Correspondence to:
 Dr P Mhawech-Fauceglia
 Department of Pathology, Oswell Park Cancer Institute, Elm and Carlton Street, Buffalo, NY 14263, USA; pmhawech1{at}


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.

  • 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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  • Published Online First 17 August 2006

  • Competing interests: None declared.