Iaconis Lori, Hyjek Elizabeth, Ellenson Lora H, Pirog Edyta C
Department of Pathology, Beth Israel Hospital, New York, NY, USA.
Arch Pathol Lab Med. 2007 Sep;131(9):1343-9. doi: 10.5858/2007-131-1343-PAKIIA.
Atypical immature squamous metaplasia (AIM) of the cervix is a loosely defined entity characterized by immature metaplastic cells with mild cytologic atypia.
To examine whether a combination of immunostaining for p16 and Ki-67 could be used to stratify AIM cases into 3 categories: benign, cases with nondiagnostic atypia, and high-grade squamous intraepithelial lesion (HSIL).
The study consisted of 37 cases of AIM, 23 cases of benign cervical mucosa (NEG), and 36 cases of HSIL. All cases were tested for high-risk human papillomaviruses using SPF 10 polymerase chain reaction and immunostained for p16 and Ki-67.
All cases of HSIL were positive for both p16 and Ki-67. All but 2 benign control cases were negative for both p16 and Ki-67. Seven cases of AIM (19%) displayed a pattern of immunostaining identical to HSIL, and these most likely represent a spectrum of HSIL. A total of 54% of cases of AIM were negative for both p16 and Ki-67, consistent with benign reactive atypia. Two AIM cases (5%) were negative for p16 and positive for Ki-67 in the area adjacent to an ulcer, representing regeneration. Finally, 22% of AIM cases were positive for p16 and negative for Ki-67; such cases may represent a precursor of HSIL or, alternatively, a regressing HSIL.
The combination of immunostaining for p16 and Ki-67 is helpful in limiting of the number of cases with nondiagnostic atypia of the cervix.
宫颈非典型不成熟鳞状化生（AIM）是一个定义不明确的实体，其特征为具有轻度细胞学非典型性的不成熟化生细胞。
探讨p16和Ki-67免疫染色联合应用是否可将AIM病例分为3类：良性、非诊断性非典型病例和高级别鳞状上皮内病变（HSIL）。
该研究包括37例AIM病例、23例良性宫颈黏膜（阴性对照）病例和36例HSIL病例。所有病例均采用SPF 10聚合酶链反应检测高危型人乳头瘤病毒，并进行p16和Ki-67免疫染色。
所有HSIL病例的p16和Ki-67均呈阳性。除2例良性对照病例外，所有良性对照病例的p16和Ki-67均为阴性。7例AIM病例（19%）的免疫染色模式与HSIL相同，这些病例很可能代表HSIL的一个谱系。共有54%的AIM病例p16和Ki-67均为阴性，符合良性反应性非典型性。2例AIM病例（5%）在溃疡附近区域p16为阴性，Ki-67为阳性，代表再生。最后，22%的AIM病例p16为阳性，Ki-67为阴性；这些病例可能代表HSIL的前驱病变，或者是消退期的HSIL。
p16和Ki-67免疫染色联合应用有助于减少宫颈非诊断性非典型病例的数量。
