横纹肌肉瘤及其亚型中FOXO1、Olig-2、ALK的表达与诊断意义OA

Objective To investigate the expression patterns and diagnostic value of FOXO1,Olig-2 and ALK in rhabdomyosarcoma(RMS)and its subtypes.Methods Clinicopathological data of 27 cases with RMS and 60 cases with related tumors(30 non-RMS small round cell tumors and 30 other soft-tissue tumors)were retrospectively ana-lyzed.Immunohistochemistry was performed to detect the immunoreactivity of FOXO1,Olig-2,ALK,MyoD1,Myo-genin and desmin.ROC curve analysis was adopted to evaluate the diagnostic performance of Olig-2,MyoD1,and Myogenin for the diagnosis of RMS and the differentiation between alveolar rhabdomyosarcoma(ARMS)and embryo-nal rhabdomyosarcoma(ERMS).Results The positive rates of FOXO1 and Olig-2 in ARMS were significantly higher than those in ERMS(P<0.05),while ALK expression showed no significant difference between the two subtypes.All three markers were negative in non-ARMS/non-ERMS subtypes.Focal positivity of FOXO1 and Olig-2 was occa-sionally seen in control groups,while ALK staining was entirely negative.ROC analysis revealed that the AUC of Olig-2 for differentiating ARMS from ERMS was 0.88,which was markedly superior to that of MyoD1 and Myogenin(AUC values were 0.60 and 0.58,respectively).The combined detection of the three markers achieved an AUC of 0.97.When differentiating RMS from non-RMS tumors,both MyoD1 and Myogenin had AUC values greater than 0.82,whereas Olig-2 exhibited high specificity and low sensitivity.Conclusion FOXO1 is a sensitive marker for screening ARMS,yet its diagnostic specificity is limited.ALK staining may provide auxiliary reference evidence for supporting the diagnosis of RMS.Olig-2 is highly expressed in ARMS and serves as a useful marker for distinguishing ARMS from ERMS.Combined immunohistochemical staining of Olig-2,MyoD1,and Myogenin is expected to optimize subtype stratification of RMS and reduce the demand for FISH detection.