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DOI: 10.5146/tjpath.2022.01578 |
TOX Outperforms FOXP3, CD4 and GATA3 in Histopathological Diagnosis of Early Mycosis Fungoides |
Mona Mostafa AHMED1 , Abdelmonem Awad HEGAZY2,3 , Ahmed EMBABY4 , Esraa Mohammad NAWWAR5 , Salwan Abdelmonem HEGAZY61 , Hanaa M. IBRAHIM1 , Mai Ahmed GOBRAN1 |
1Department of Pathology, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT
2Department of Human Anatomy and Embryology, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT
3Department of Medical Biotechnology, Misr University for Science and Technology (MUST), College of Biotechnology, SIX OF OCTOBER CITY, EGYPT
4Department of Internal Medicine, Faculty of Medicine, Zagazig University, ZAGAZIG, EGYPT
5Department of Dermatology, Al-Ahrar Teaching Hospital and Zagazig University Hospitals, ZAGAZIG, EGYPT
6Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT |
Keywords:
Mycosis fungoides, Benign inflammatory dermatoses, Differential histopathological diagnosis, Immunohistochemical markers |
Objective: Mycosis fungoides (MF) is the most common type of cutaneous lymphoma. The early stage of MF is a difficult diagnostic case, as it
is often confused with many benign inflammatory dermatoses (BID). The study aimed to evaluate the diagnostic utility of TOX, FOXP3, CDD4
and GATA3 in differentiating early stages of MF from histologically overlapping BID lesions.
Material and Method: A retrospective cross-sectional study was performed, in which immunohistochemistry (IHC) was used to evaluate the
expression of TOX, FOXP3, CD4 and GATA3 in formalin-fixed paraffin-embedded (FFPE) sections of skin lesions from 30 cases with BID and
30 patients with early-stage MF.
Results: The association between TOX expression and early-stage MF was statistically significant (P <0.001). TOX had the highest sensitivity of
96.77% and accuracy of 85.71% in diagnosis of MF; followed by CD4 with sensitivity of 85.71% and accuracy of 78.95%; and then, GATA3 with
sensitivity of 76.7% and finally FOXP3 with sensitivity of 70.0%.
Conclusion: TOX is suggested to be of higher diagnostic value in the early stages of MF than the conventionally used CD4 and other markers
examined.
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