Driemel O, Dahse R, Berndt A, Pistner H, Hakim S G, Zardi L, Reichert T E, Kosmehl H
Department of Oral and Maxillofacial Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
Clin Oral Investig. 2007 Mar;11(1):93-9. doi: 10.1007/s00784-006-0086-8. Epub 2006 Nov 17.
Tumour-invasion like wound healing is characterised by the formation of an extracellular matrix with a high tenascin-C content. The tenascin-C molecule undergoes alternative splicing. Analysis using antibody BC2 indicates that especially the high-molecular tenascin-C (hm tn-C) variants are typically tumour-associated, while distribution in normal tissue is restrictive. This study investigated whether hm tn-C is a suitable indicator of atypical cells with invasive potential in oral brush biopsies. One hundred fifty nine consecutive oral brush biopsies with histopathological diagnoses were analysed for the identification of atypical cells. A standardised haematoxylin and eosin staining plus standardised immunocytochemistry using the monoclonal anti-hm tn-C antibody was performed. The bound hm tn-C antibodies were detected with the streptavidine/alkaline phosphatase technique in the autostainer. Conventional cytology produced four false-positives when identifying atypical cells in brush biopsies of inflammatory/benign hyperproliferative mucosa (specificity 96%), while 10 in 52 carcinomas and three of eight recurrences were not identified (sensitivity 78%). Ten of these 13 non-identified tumours could be marked when adding the hm tn-C assay (increasing specificity to 99%). Combining the two assays also reduced the false-positive outcomes from four to one (increasing sensitivity to 95%). The positive and negative predictive values were 92 and 88% for conventional cytology vs 98 and 97% for the dual assay. (1) A 95%-sensitivity proves hm tn-C assisted conventional cytology to be a suitable means of identifying atypical cells in oral brush biopsies. (2) The positive (98%) and negative (97%) predictive values obtained approximate hm tn-C assisted conventional cytology to laminin-5 (100/97%).
肿瘤侵袭类似于伤口愈合，其特征是形成富含腱生蛋白-C的细胞外基质。腱生蛋白-C分子会发生可变剪接。使用抗体BC2进行的分析表明，特别是高分子量腱生蛋白-C（hm tn-C）变体通常与肿瘤相关，而在正常组织中的分布有限。本研究调查了hm tn-C是否是口腔刷检活检中具有侵袭潜能的非典型细胞的合适指标。对159例连续的经组织病理学诊断的口腔刷检活检进行分析，以识别非典型细胞。进行了标准化的苏木精和伊红染色以及使用单克隆抗hm tn-C抗体的标准化免疫细胞化学。在自动染色仪中用链霉亲和素/碱性磷酸酶技术检测结合的hm tn-C抗体。传统细胞学在识别炎症/良性增生性黏膜刷检活检中的非典型细胞时产生了4例假阳性（特异性96%），而52例癌中有10例以及8例复发中有3例未被识别（敏感性78%）。当增加hm tn-C检测时，这13例未被识别的肿瘤中有10例可以被标记出来（特异性提高到99%）。将两种检测方法结合也将假阳性结果从4例减少到1例（敏感性提高到95%）。传统细胞学的阳性和阴性预测值分别为92%和88%，而双重检测的阳性和阴性预测值分别为98%和97%。（1）95%的敏感性证明hm tn-C辅助的传统细胞学是识别口腔刷检活检中非典型细胞的合适方法。（2）获得的阳性（98%）和阴性（97%）预测值接近hm tn-C辅助的传统细胞学与层粘连蛋白-5的预测值（100/97%）。
