Evidence map›Paper›PMID 29327709›Full record

ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2018

INSM1 expression and its diagnostic significance in extraskeletal myxoid chondrosarcoma.

Akihiko Yoshida, Naohiro Makise, Susumu Wakai, Akira Kawai, Nobuyoshi Hiraoka

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In one paragraph

Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
6.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 78 citations in OpenAlex.

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  7. Framework for the Pathology Workup of Metastatic Castration-Resistant Prostate Cancer Biopsies.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
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  18. Lung neuroendocrine neoplasms: recent progress and persistent challenges.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Akihiko YoshidaDepartment of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
Naohiro MakiseDepartment of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.ORCID 0000-0002-6991-747X
Susumu WakaiDepartment of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
Akira KawaiRare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
Nobuyoshi HiraokaDepartment of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
Tokyo National Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Extraskeletal myxoid chondrosarcoma is a rare subtype of sarcoma that affects the soft tissue and bones in middle-aged and elderly adults. Its diagnosis can be challenging, with the differential diagnoses including a wide variety of mesenchymal tumors. The line of differentiation of extraskeletal myxoid chondrosarcoma has been controversial, but recent evidence suggests a neuroendocrine phenotype. INSM1 is a zinc-finger transcription factor that plays a pivotal role in neuroendocrine differentiation, and has been proposed as a promising immunohistochemical marker of neuroendocrine carcinoma. The aim of this study was to determine the prevalence of INSM1 expression in extraskeletal myxoid chondrosarcoma and to understand its significance in sarcoma diagnosis. We immunostained the representative sections of 31 NR4A3-rearranged extraskeletal myxoid chondrosarcomas and 187 histological mimics. Nuclear staining of moderate or higher intensity in at least 5% of tumor cells was considered positive. Twenty-eight of the 31 extraskeletal myxoid chondrosarcomas (90%) were positive for INSM1, providing strong evidence for neuroendocrine differentiation. The staining was diffuse (>50%) in 17 cases, with most immunopositive tumors showing at least focal strong expression. The INSM1 staining extent was not correlated with cytomorphology, synaptophysin expression, or fusion types (EWSR1 vs non-EWSR1). In contrast, INSM1 expression was negative in 94% of the 187 other mesenchymal tumors. INSM1-positive mimics comprised a small subset of chordoma (1 of 10), soft tissue myoepithelioma (1 of 20), ossifying fibromyxoid tumor (3 of 10), and Ewing sarcoma (3 of 10), among other tumor types. The majority of these cases showed labeling in <25% of the tumor cells. Although not entirely sensitive or specific, INSM1 could be a potential marker for the diagnosis of extraskeletal myxoid chondrosarcoma when molecular genetic access is limited.

Indexed as

AdultAgedAged, 80 and overBiomarkers, TumorChondrosarcomaDNA-Binding ProteinsFemaleGene ExpressionHumansImmunohistochemistryMaleMiddle AgedNeoplasms, Connective and Soft TissueReceptors, SteroidReceptors, Thyroid HormoneRepressor ProteinsBiomarkers, TumorDNA-Binding ProteinsEWSR1 protein, humanINSM1 protein, humanNR4A3 protein, humanReceptors, SteroidReceptors, Thyroid HormoneRepressor ProteinsRNA-Binding Protein EWSSynaptophysin

Identifiers

PMID29327709
OpenAlexW2783489435

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.