Lumachi Franco, Ermani Mario, Marino Filippo, Iacobone Maurizio, Baldessin Monica, Cappuzzo Gianluca, Zanella Simone, Favia Gennaro
Endocrine Surgery Unit, Department of Surgical and Gastroenterological Sciences, University of Padua, School of Medicine, 35128 Padova, Italy.
Anticancer Res. 2006 Mar-Apr;26(2A):1305-8.
Parathyroid carcinoma is uncommon and no reliable histological markers are available for predicting the clinical outcome of patients. The aim of this study was to assess the correlation between survival, histopatological markers, proliferating cell nuclear antigen (PCNA), Ki-67 antigen and the expression of the p53 nuclear protein in patients with confirmed parathyroid carcinoma (PC). The routine histological specimens from 15 patients (11 men, 4-women, median age 65 years) with confirmed PC who had died of the disease were reviewed. New specimens were also stained with the streptavidin-biotin-peroxidase complex standard technique. The labelling index (LI) of PCNA was quantified by counting 1000 cells from multiple areas in a random fashion, while immunostaining of both Ki-67 and p53 was evaluated as the percentage of positive cells. The PCNA-LI, Ki-67 (%) and p53 (%) values were 14.9 +/- 4.1 (median 13, range 2-70), 13.9 +/- 3.9 (median 11%, range 3-65%) and 38.5 +/- 4.6 (median 29%, range 19-65%), respectively. There was an inverse correlation between age of the patients and p53 (R = -0.73, p = 0.002), but no correlation with both PCNA-LI (R = 0.07, p = 0.72) and Ki-67 (R = -0.07, p = 0.79). A significant relationship (R = 0.93, p < 0.01) between PCNA-LI and Ki-67 was found, while p53 did not correlate with either PCNA-LI (R = -0.11, p = 0.71) or Ki-67 (R = -0.05, p = 0.86). An inverse correlation (R = -0.63, p = 0.01) between survival and the presence of spindle cells and coagulation necrosis together in the standard slides was observed, but there was no correlation (p = NS) between survival and PCNA-LI (R = 0.05), Ki -67 (R = 0.05) or p53 (R = 0.25). In conclusion, none of the tested immunohistochemical markers were useful in predicting the clinical outcome of patients with PC. However, the presence of spindle cells and coagulation necrosis together in the standard specimens should be considered as a negative prognostic factor.
甲状旁腺癌并不常见，目前尚无可靠的组织学标志物可用于预测患者的临床结局。本研究的目的是评估确诊为甲状旁腺癌（PC）患者的生存期、组织病理学标志物、增殖细胞核抗原（PCNA）、Ki-67抗原及p53核蛋白表达之间的相关性。回顾了15例确诊为PC且已死于该病的患者（11例男性，4例女性，中位年龄65岁）的常规组织学标本。新标本也采用链霉亲和素-生物素-过氧化物酶复合物标准技术进行染色。PCNA的标记指数（LI）通过随机从多个区域计数1000个细胞来定量，而Ki-67和p53的免疫染色则以阳性细胞百分比来评估。PCNA-LI、Ki-67（%）和p53（%）值分别为14.9±4.1（中位数13，范围2 - 70）、13.9±3.9（中位数11%，范围3 - 65%）和38.5±4.6（中位数29%，范围19 - 65%）。患者年龄与p53之间呈负相关（R = -0.73，p = 0.002），但与PCNA-LI（R = 0.07，p = 0.72）和Ki-67（R = -0.07，p = 0.79）均无相关性。发现PCNA-LI与Ki-67之间存在显著相关性（R = 0.93，p < 0.01），而p53与PCNA-LI（R = -0.11，p = 0.71）或Ki-67（R = -0.05，p = 0.86）均无相关性。在标准切片中观察到生存期与梭形细胞和凝固性坏死同时存在之间呈负相关（R = -0.63，p = 0.01），但生存期与PCNA-LI（R = 0.05）、Ki -67（R = 0.05）或p53（R = 0.25）之间无相关性（p = 无显著性差异）。总之，所检测的免疫组化标志物均无助于预测PC患者的临床结局。然而，标准标本中同时存在梭形细胞和凝固性坏死应被视为不良预后因素。
