Abstract
BackgroundAlthough the diagnosis of chondrosarcoma, especially the distinction between enchondroma and low-grade chondrosarcoma or low-grade chondrosarcoma and high-grade chondrosarcoma, is pathologically difficult, differential diagnosis is very important because the treatment strategies for these diseases are completely different. The grading system is crucial in predicting biologic behavior and prognosis, however, exact pathological grading is difficult using only routine examinations because the criteria of the grading system are not necessarily definitive. Growth arrest and DNA damage-inducible protein 45β (GADD45β) is an essential molecule for chondrocytes during terminal differentiation. In the present study, we investigated the immunohistochemical expression of GADD45β in enchondroma, and chondrosarcoma of histological grades I, II, and III, to clarify the diagnostic significance of GADD45β in pathological grading of chondrosarcoma.MethodsTwenty samples (enchondroma = 6, chondrosarcoma grade I = 7, grade II = 6, grade III = 1) were used for immunohistochemical analysis to investigate the expression of GADD45β. Quantitative analysis was performed to compare the number of GADD45β positive cells and pathological grading.ResultsOver 70% of the cells in enchondromas expressed GADD45β. On the other hand, the expression of GADD45β decreased significantly according to the histological grade of chondrosarcoma (grade I: 45%; grade II: 13.8%; and grade III: 3.8%).ConclusionsThe association of GADD45β expression and pathological grading of chondrosarcoma in the present study suggests that the immunohistochemical study of GADD45β may be a specific diagnostic parameter for chondrosarcoma cell differentiation.
Highlights
The diagnosis of chondrosarcoma, especially the distinction between enchondroma and low-grade chondrosarcoma or low-grade chondrosarcoma and high-grade chondrosarcoma, is pathologically difficult, differential diagnosis is very important because the treatment strategies for these diseases are completely different
We investigated the immunohistochemical expression of Growth arrest and DNA damage-inducible protein 45b (GADD45b) in enchondroma and chondrosarcoma of histological grades I, II, and III, to clarify the diagnostic significance of GADD45b in histological grading of chondrosarcoma
In the case of chondrosarcomas, the percentage of GADD45b positive cells was inversely proportional to the tumor grade
Summary
The diagnosis of chondrosarcoma, especially the distinction between enchondroma and low-grade chondrosarcoma or low-grade chondrosarcoma and high-grade chondrosarcoma, is pathologically difficult, differential diagnosis is very important because the treatment strategies for these diseases are completely different. Chondrosarcoma is the second most frequent primary malignant bone tumor [1,2]. Because of its recalcitrance to chemotherapy and radiotherapy, chondrosarcoma is primarily treated with surgery, and the clinical prognosis of chondrosarcoma has been correlated with the grading of the histological malignancy [3]. For pathological consideration, distinguishing benign (enchondroma) from low-grade chondrosarcoma, or lowgrade chondrosarcoma from high-grade chondrosarcoma, Enchondroma is a very common and benign cartilaginous tissue tumor that occurs within bones. The pathological distinction between enchondroma and low-grade chondrosarcoma is, not always easy because of their similar cytology and cellularity. Chondrosarcoma is primarily a tumor of adulthood and old age
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