Mittal K, Demopoulos R I
Kaplan Cancer Center, New York University School of Medicine and Medical Center, New York, NY, USA.
Hum Pathol. 2001 Sep;32(9):984-7. doi: 10.1053/hupa.2001.27113.
The diagnosis of benign, uncertain malignant potential, and malignant uterine smooth muscle tumors depends on mitotic counts, nuclear atypia, and other morphologic features. This study was undertaken to evaluate the utility of selected immunohistochemical markers in differentiating these tumors. Fifteen cases of cellular leiomyoma, 7 cases of smooth muscle tumor of uncertain malignant potential (STUMP), and 12 cases of leiomyosarcoma were immunostained for MIB-1 (Ki-67), p53, estrogen receptor and progesterone receptor (PR) using monoclonal antibodies and the avidin-biotin-peroxidase method. The percentage of cells stained was subjectively assessed to the nearest 5%. One percent was used for rare positive cells. MIB-1 expression of > or =15% was seen in 11 and expression of p53 in > or =15% cells was present in 5 of 12 leiomyosarcomas. MIB-1 and/or p53 expression of >15% was seen in all 12 leiomyosarcomas but in none of the 7 STUMP or 15 cellular leiomyomas. PR was absent in 10 of 12 leiomyosarcomas but present in 7 of 7 STUMP and 14 of 15 cellular leiomyomas. MIB-1 of 5% to 10% was seen in 6 of 7 STUMP but in only 1 of 15 cellular leiomyomas. MIB-1, p53, and PR are useful in differentiating leiomyosarcoma from STUMP and cellular leiomyoma. MIB-1 is useful in distinguishing STUMP from cellular leiomyomas.
良性、恶性潜能不确定及恶性子宫平滑肌肿瘤的诊断取决于有丝分裂计数、核异型性及其他形态学特征。本研究旨在评估所选免疫组化标志物在鉴别这些肿瘤中的作用。采用单克隆抗体及抗生物素蛋白-生物素-过氧化物酶法，对15例富于细胞性平滑肌瘤、7例恶性潜能不确定的平滑肌瘤（STUMP）及12例平滑肌肉瘤进行MIB-1（Ki-67）、p53、雌激素受体和孕激素受体（PR）免疫染色。主观评估染色细胞的百分比，精确到最接近的5%。罕见阳性细胞计为1%。12例平滑肌肉瘤中有11例MIB-1表达≥15%，5例p53表达≥15%。12例平滑肌肉瘤中均可见MIB-1和/或p53表达>15%，但7例STUMP和15例富于细胞性平滑肌瘤中均未出现。12例平滑肌肉瘤中有10例PR缺失，而7例STUMP中有7例、15例富于细胞性平滑肌瘤中有14例PR存在。7例STUMP中有6例MIB-1表达为5%至10%，而15例富于细胞性平滑肌瘤中仅有1例。MIB-1、p53和PR有助于鉴别平滑肌肉瘤与STUMP及富于细胞性平滑肌瘤。MIB-1有助于区分STUMP与富于细胞性平滑肌瘤。
