Rath-Wolfson Lea, Rosenblat Yevgenia, Halpern Marisa, Herbert M, Hammel I, Gal Rivka, Leabu M, Koren Rumelia
Department of Pathology, Hasharon Hospital, Rabin Medical Center, Petah-Tikva, Israel.
J Cell Mol Med. 2006 Jan-Mar;10(1):197-205. doi: 10.1111/j.1582-4934.2006.tb00300.x.
The diagnosis of uterine smooth muscle neoplasms by light microscopy is difficult. Multiple classification schemes have been proposed based on mitotic rate, nuclear atypia, and the presence or absence of necrosis. None of these classification systems has been entirely successful. This study was undertaken to evaluate the use of selected immunohistochemical and histochemical markers in differentiating these tumors, in addition to accepted morphologic criteria. Ten cases of each of the following: leiomyosarcomas (LMS), atypical leiomyomas (AL), cellular leiomyomas (CL) and usual leiomyomas (UL), were classically evaluated for histological diagnosis and were stained for Ki-67 (MIB-1), bcl- 2 and p53 using monoclonal antibodies and the avidin-biotin peroxidase method, and argyrophilic nucleolar organizer region (AgNORs). The number of stained cells was counted in the most positively stained region in a 4 mm2 square cover glass mounted on each slide. The mean value was calculated for each group of tumors. The data for Ki-67 (MIB- 1), bcl-2, p53 and AgNOR staining respectively, were significantly higher in LMS by comparison to UL, CL or AL. Because many singular cases had superimposed data being difficult to diagnose, a new scoring system for pathological evaluation was created. The results obtained by this scoring system suggest that immunohistochemical markers Ki-67 (MIB-1), bcl-2, p53 together with the AgNOR staining could be useful, by the scoring system, as an adjunct to the current accepted morphologic criteria in differentiating smooth muscle tumors of the uterus.
通过光学显微镜诊断子宫平滑肌肿瘤很困难。基于有丝分裂率、核异型性以及有无坏死，已经提出了多种分类方案。但这些分类系统都没有完全成功。本研究旨在评估除了公认的形态学标准外，选用的免疫组织化学和组织化学标志物在鉴别这些肿瘤中的应用。对以下每种肿瘤各10例：平滑肌肉瘤（LMS）、非典型平滑肌瘤（AL）、富于细胞平滑肌瘤（CL）和普通平滑肌瘤（UL），进行经典的组织学诊断评估，并使用单克隆抗体和抗生物素蛋白-生物素过氧化物酶法对Ki-67（MIB-1）、bcl-2和p53进行染色，以及进行嗜银核仁组织区（AgNORs）染色。在安装在每张载玻片上的4平方毫米方形盖玻片的最阳性染色区域中计数染色细胞的数量。计算每组肿瘤的平均值。与UL、CL或AL相比，LMS中Ki-67（MIB-1）、bcl-2、p53和AgNOR染色的数据分别显著更高。由于许多个别病例的数据重叠难以诊断，因此创建了一种新的病理评估评分系统。该评分系统获得的结果表明，免疫组织化学标志物Ki-67（MIB-1）、bcl-2、p53以及AgNOR染色，通过该评分系统，可作为当前公认的形态学标准的辅助手段，用于鉴别子宫平滑肌肿瘤。
