Lörinc E, Jakobsson B, Landberg G, Veress B
Division of Pathology, Department of Clinical Pathology and Cytology, University Hospital MAS, Malmö, Sweden.
Histopathology. 2005 Jun;46(6):642-8. doi: 10.1111/j.1365-2559.2005.02139.x.
To devise clinically applicable methods for assessing p53 and Ki67 immunohistochemical (IHC) reactivity in Barrett's oesophagus (BE) and to compare the interobserver agreement between these methods and routine haematoxylin and eosin (H&E) evaluation.
One hundred and fifteen biopsies diagnosed as BE, selected from the files of the University Hospital MAS, Malmo, were re-evaluated for dysplasia by three pathologists. For IHC analysis areas with the most prominent positivity were evaluated. The mean of p53+ epithelial nuclei/high-power field (HPF) was obtained by counting between 1 and 5 HPFs/biopsy. A proliferation quotient (PQ) was obtained by dividing the number of Ki67+ epithelial nuclei in the upper half by the lower half of the mucosa, using two HPFs. Mean kappa values were 0.24, 0.71 and 0.52 for H&E, p53 and Ki67 evaluations, respectively. There was a correlation between increasing severity of dysplasia, IHC measurable overexpression of p53 and shift of the mucosal proliferation zone towards the surface, measured as PQ.
The described methods for p53 and Ki67 evaluation are more reproducible than routine H&E evaluation of BE. Furthermore, the IHC methods correlate with the severity of dysplasia and are useful supplementary prognostic markers.
设计临床适用的方法来评估巴雷特食管（BE）中p53和Ki67免疫组化（IHC）反应性，并比较这些方法与常规苏木精和伊红（H&E）评估之间的观察者间一致性。
从马尔默大学医院MAS的档案中选取115例诊断为BE的活检标本，由三位病理学家重新评估发育异常情况。对于IHC分析，评估阳性最显著的区域。通过对每份活检标本计数1至5个高倍视野（HPF）来获得p53 +上皮细胞核/高倍视野（HPF）的平均值。使用两个高倍视野，通过将黏膜上半部分Ki67 +上皮细胞核的数量除以下半部分的数量来获得增殖指数（PQ）。H&E、p53和Ki67评估的平均kappa值分别为0.24、0.71和0.52。发育异常严重程度增加、IHC可测量的p53过表达与黏膜增殖区向表面的移位（以PQ衡量）之间存在相关性。
所描述的p53和Ki67评估方法比BE的常规H&E评估更具可重复性。此外，IHC方法与发育异常的严重程度相关，是有用的辅助预后标志物。
