Comparative analysis of Napsin A, alpha-methylacyl-coenzyme A racemase ( @entity6639 , @entity12877 ), and XXXX as diagnostic markers of @entity43 : an immunohistochemical study of 279 @entity43 .

@entity12877 @entity43 @entity5 @entity5456 @entity189 @entity134 @entity1358 @entity6639 @entity4348 @entity5000
SUMMARY: Napsin A and @entity6639 ( @entity6639 , @entity12877 ) have recently been described as being frequently expressed in @entity1358 ( @entity1358 ) of the gynecological tract. The present study was conducted to assess the test performance of these newer markers relative to the more traditional marker, @entity5456 ( @entity5456 ), in a large and histotypically diverse dataset. A total of 279 @entity43 in tissue microarrays were immunohistochemically assessed for the expression of Napsin A, @entity6639 and @entity5456 . @entity5456 , Napsin A and @entity6639 were expressed in 92%, 82% and 63% of 65 @entity1358 , 7%, 1% and 1% of 101 @entity189 , 37%, 5.3% and 0% of 19 @entity4348 , 60%, 0% and 0% of 45 @entity5 , 100%, 0% and 0% of seven yolk sac @entity5 , and 0%, 16.7% and 16.7% of six @entity134 cell @entity5 NOS, respectively. All other @entity5 , including 18 adult-type granulosa cell @entity5 , @entity5000 and nine other miscellaneous @entity5 types were negative for all three markers. Using a benchmark of >= 1% of @entity5 cells for positivity and @entity1358 as the diagnostic end-point, the sensitivity, specificity, negative predictive value and positive predictive value of Napsin A expression were 0.82, 0.99, 0.94, and 0.98, respectively (odds ratio 439, p<0.0001). Respective parameters were 0.92, 0.79, 0.97, and 0.58 (odds ratio 44, p<0.0001) for @entity5456 and 0.63, 0.99, 0.89, and 0.5 (odds ratio 112, p<0.0001) for @entity6639 . The combination of any two positive markers, irrespective of the staining pattern of the third, significantly predicted the @entity1358 histotype in every analytic scenario. In summary, @entity5456 is highly sensitive but is suboptimally specific in isolation, whereas @entity6639 is highly specific but is suboptimally sensitive. Napsin A is specific but of intermediate sensitivity. Napsin A, @entity6639 and @entity5456 are all viable markers of @entity1358 that can be deployed as components of larger panels when @entity1358 is a diagnostic consideration.
