Sington J D, Morris L S, Nicholson A G, Coleman N
Department of Cellular Pathology, Stoke Mandeville Hospital, Aylesbury, UK.
Histopathology. 2003 May;42(5):498-502. doi: 10.1046/j.1365-2559.2003.01628.x.
The differentiation of benign pleural conditions from malignant mesothelioma may be difficult, especially with a small biopsy. We have tested the hypothesis that assessment of the cell cycle status is of value in the histopathological diagnosis of such biopsies, by comparing 33 malignant mesotheliomas with 36 cases of reactive mesothelial hyperplasia and reactive pleural fibrosis.
Biopsies were investigated for proliferative status by immunostaining for a novel antibody, MCM2, all of which showed nuclear expression of MCM2 at higher frequency than Ki67 (P < 0.0001). Counts in areas of maximum tumour staining showed significantly higher labelling indices (LIMax) in epithelioid and sarcomatoid mesotheliomas compared with reactive mesothelial hyperplasia and reactive pleural fibrosis (P < 0.0001 for both). Average counts (LIAve) revealed a significant increase in epithelioid mesothelioma compared with reactive mesothelial hyperplasia (P < 0.0001).
We consider MCM2 to be a useful adjunct in the differential diagnosis of malignant mesothelioma.
良性胸膜疾病与恶性间皮瘤的鉴别诊断可能存在困难，尤其是在活检组织较小的情况下。我们通过比较33例恶性间皮瘤与36例反应性间皮细胞增生和反应性胸膜纤维化病例，检验了细胞周期状态评估在这类活检组织的组织病理学诊断中具有价值这一假设。
通过对一种新型抗体MCM2进行免疫染色来研究活检组织的增殖状态，所有病例中MCM2的核表达频率均高于Ki67（P<0.0001）。在肿瘤染色最强的区域计数显示，上皮样和肉瘤样间皮瘤的标记指数（LIMax）显著高于反应性间皮细胞增生和反应性胸膜纤维化（两者P均<0.0001）。平均计数（LIAve）显示，上皮样间皮瘤与反应性间皮细胞增生相比有显著增加（P<0.0001）。
我们认为MCM2在恶性间皮瘤的鉴别诊断中是一种有用的辅助手段。
