An immunohistochemical panel of CDK4, MDM2, and p16 detected well-differentiated and dedifferentiated liposarcomas with 71% sensitivity and 98% specificity, with p16 being the most accurate marker.
Observational (n=216)
Does an immunohistochemical panel of p16, CDK4, and MDM2 accurately distinguish well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors?
An immunohistochemical panel of CDK4, MDM2, and p16 is highly specific for distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors, with p16 being the most sensitive and specific individual marker.
Adipocytic tumors are the most common type of soft tissue neoplasms. Distinguishing atypical lipomatous tumor-well-differentiated liposarcoma (WDL) from benign adipocytic neoplasms and dedifferentiated liposarcoma (DDL) from pleomorphic or myxoid liposarcoma (LPS) can be difficult. WDL and DDL characteristically harbor amplifications of the MDM2 and CDK4 cell cycle oncogenes with protein overexpression and can also overexpress the cell cycle regulator p16. We assessed the utility of immunohistochemistry for CDK4, MDM2, and p16 in the routine histopathologic diagnosis of WDL/DDL from other adipocytic tumors. Immunohistochemistry for the trio of markers was performed on 216 adipocytic neoplasms (31 WDLs, 57 DDLs, 11 myxoid LPS, 2 pleomorphic LPS, 91 lipomas (including intramuscular, fibro, angio, and ossifying subtypes), 18 spindle/pleomorphic lipomas, and 6 hibernomas. Sixty-eight percent of WDLs and 72% of DDLs expressed all 3 antigens, whereas 100% of WDLs and 93% of DDLs expressed at least 2 antigens. The sensitivity and specificity of the trio for detecting WDLs/DDLs were 71% and 98%, respectively. The sensitivity and specificity of CDK4 for detecting WDLs/DDLs were 86% and 89%, those of MDM2 were 86% and 74%, and those of p16 were 93% and 92%, respectively. The immunohistochemical trio of CDK4, MDM2, and p16 is a useful ancillary diagnostic tool that provides strong support in distinguishing WDLs and DDLs from other adipocytic neoplasms and is potentially more sensitive than previously assessed combinations of CDK4 and MDM2. p16 was the most sensitive and specific marker for detecting WDL/DDL, and the combination of CDK4 and p16 is of more discriminatory value than the combination of either with MDM2, the least sensitive and specific of the 3 markers.
Thway et al. (2012) conducted an observational in Adipocytic tumors (n=216). Immunohistochemistry for CDK4, MDM2, and p16 was evaluated on Sensitivity and specificity for detecting well-differentiated and dedifferentiated liposarcomas. An immunohistochemical panel of CDK4, MDM2, and p16 detected well-differentiated and dedifferentiated liposarcomas with 71% sensitivity and 98% specificity, with p16 being the most accurate marker.