Publikation

Robust diagnosis of Ewing sarcoma by immunohistochemical detection of super-enhancer-driven EWSR1-ETS targets

Wissenschaftlicher Artikel/Review - 04.08.2017

Bereiche
PubMed
DOI

Zitation
Baldauf M, Akatli A, Özen Ö, Dirksen U, Hartmann W, de Alava E, Baumhoer D, Sannino G, Kirchner T, Akpolat N, Li J, Ohmura S, Orth M, Dallmayer M, Marchetto A, Gerke J, Rubio R, Kiran M, Musa J, Knott M, Grünewald T. Robust diagnosis of Ewing sarcoma by immunohistochemical detection of super-enhancer-driven EWSR1-ETS targets. Oncotarget 2017; 9:1587-1601.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Oncotarget 2017; 9
Veröffentlichungsdatum
04.08.2017
eISSN (Online)
1949-2553
Seiten
1587-1601
Kurzbeschreibung/Zielsetzung

Ewing sarcoma is an undifferentiated small-round-cell sarcoma. Although molecular detection of pathognomonic fusions such as enables definitive diagnosis, substantial confusion can arise if molecular diagnostics are unavailable. Diagnosis based on the conventional immunohistochemical marker CD99 is unreliable due to its abundant expression in morphological mimics. To identify novel diagnostic immunohistochemical markers for Ewing sarcoma, we performed comparative expression analyses in 768 tumors representing 21 entities including Ewing-like sarcomas, which confirmed that , , , and -translocated sarcomas are distinct entities, and revealed that , , and constitute specific markers for Ewing sarcoma. Their high expression was validated by immunohistochemistry and proved to depend on EWSR1-FLI1-binding to highly active proximal super-enhancers. Automated cut-off-finding and combination-testing in a tissue-microarray comprising 174 samples demonstrated that detection of high BCL11B and/or GLG1 expression is sufficient to reach 96% specificity for Ewing sarcoma. While 88% of tested Ewing-like sarcomas displayed strong CD99-immunoreactivity, none displayed combined strong BCL11B- and GLG1-immunoreactivity. Collectively, we show that , , and are EWSR1-FLI1 targets, of which BCL11B and GLG1 offer a fast, simple, and cost-efficient way to diagnose Ewing sarcoma by immunohistochemistry. These markers may significantly reduce the number of misdiagnosed patients, and thus improve patient care.