CK7与p16对CIN 2预后判断作用的比较

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  ——本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意,否则追究法律责任。
  宫颈上皮内瘤变(cervical intraepithelial neoplasi, CIN)2级是一种模棱两可的诊断,目前推荐使用p16免疫组织化学染色阳性帮助确认诊断。最近研究发现,几乎所有的CIN 2和CIN 3都表达鳞柱交界部细胞的特征性生物学标记。表达鳞柱交界部标记物[尤其是细胞角蛋白7(cytokeratin7, CK7)]的CIN 1病变与更高的继发性高级别鳞状上皮内病变发生率相关,这提示CK7可能成为一种判断CIN 1预后有意义的标记物。我们对一组形态学上符合CIN 2的病例进行CK7标记,并与p16的染色结果作对比,试图观察CK7作为一种预后标记物的价值。我们对116例原诊断为CIN 2的病例进行CK7免疫组织化学染色,其中,68.1%病例为p16+, 90.5%病例为CK7+。在后续活检或手术切除标本中,19.5%的患者被诊断为CIN 3;这部分病例的CIN 2病变都表达CK7+(敏感性100%),而只有1例未表达p16+(21/22,敏感性95.5%)。P16和CK7预测进展为CIN 3的特异性分别为37.4%和8.0%,差异具有统计学意义(P<0.001)。p16的表达与进展为CIN 3显著相关(P=0.002),而CK7表达与之无明显相关性(P=0.202)。我们得出结论,CK7对CIN 2的预后提示作用不如p16。但CK7仍是一种较好的CIN 1预后标记物,还需要更多的研究来确定最佳的染色/评判标准。
Am J Surg Pathol 2018;42:479-484
美国外科病理学杂志中文版2018年第三期摘要No.3
王昀 翻译 刘爱军 审校
  The American Journal of Surgical Pathology中文版声明:
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