Mittal K
Department of Pathology, New York University School of Medicine, New York 10016, USA.
Adv Anat Pathol. 1999 Jul;6(4):177-85. doi: 10.1097/00125480-199907000-00001.
Various cervical lesions at times may be difficult to distinguish from one another on routine hematoxylin and eosin stains, and immunostaining for the proliferation-associated antigen Ki-67, using monoclonal antibody MIB-1, can aid their distinction. The reduced MIB-1 expression in atrophy and increased MIB-1 expression in dysplasia permits easy distinction between these conditions. Presence of MIB-1 in more than 15% of basal cells and/or in surface half of the epithelium favor a diagnosis of condyloma over squamous metaplasia or inflammatory changes. Normal endocervix shows MIB-1 positivity in less than 10% of the cells, but usually in more than 20% of cells in cervical adenocarcinoma. With increasing grade of dysplasia, the percentage of MIB-1 positive cells is increased, and positive cells are seen in the higher levels of the epithelium. Presence of more than 20% MIB-1 positive cells in Pap smears showing atypical cells of uncertain significance is associated with a diagnosis of dysplasia on subsequent biopsies. Cauterized tissues with dysplasia show MIB-1 expression similar to adjacent noncauterized dysplastic areas. MIB-1 expression is, therefore, useful in evaluating various cervical lesions.
有时，在常规苏木精和伊红染色下，各种宫颈病变可能难以相互区分，而使用单克隆抗体MIB-1对增殖相关抗原Ki-67进行免疫染色有助于区分这些病变。萎缩时MIB-1表达降低，发育异常时MIB-1表达增加，这使得很容易区分这些情况。超过15%的基底细胞和/或上皮表面一半存在MIB-1，相较于鳞状化生或炎症改变，更支持尖锐湿疣的诊断。正常宫颈内膜在不到10%的细胞中显示MIB-1阳性，但在宫颈腺癌中通常超过20%的细胞呈阳性。随着发育异常程度的增加，MIB-1阳性细胞的百分比增加，且在上皮较高层可见阳性细胞。在显示意义不明确的非典型细胞的巴氏涂片中，超过20%的MIB-1阳性细胞与后续活检诊断为发育异常相关。有发育异常的烧灼组织显示出与相邻未烧灼的发育异常区域相似的MIB-1表达。因此，MIB-1表达在评估各种宫颈病变中很有用。
