Halloush Ruba A, Akpolat Ilkser, Jim Zhai Qihui, Schwartz Mary R, Mody Dina R
Department of Pathology, The Methodist Hospital, Houston, Texas, USA.
Cancer. 2008 Dec 25;114(6):474-80. doi: 10.1002/cncr.23951.
Although liquid-based cervicovaginal cytology has high sensitivity for detecting dysplastic/malignant lesions, many pitfalls exist. Cell blocks can be prepared from residual liquid-based cervicovaginal material and used for immunohistochemistry. The aim of this study was to evaluate a new marker, ProEx C, on cell blocks and its ability to distinguish dysplastic/malignant lesions from morphologically abnormal but benign cells. The results of this study were compared with previously reported results for p16 and Ki-67 on the same material.
ProEx C is a cocktail of monoclonal antibodies against proteins associated with aberrant S phase cell cycle induction (topoisomerase IIA, minichromosome maintenance protein 2). ThinPrep (CytycCorp., Boxborough, Mass) cervicovaginal specimens from 79 patients were selected. Four cases had no residual abnormal cells in the cell block. On the basis of the cell block diagnosis, 29 cases were negative for intraepithelial lesion or malignancy (NILM), 27 had low-grade squamous intraepithelial lesions (LSIL), 16 had high-grade squamous intraepithelial lesions (HSIL), and 3 had squamous cell carcinomas (SCC). Cell block sections were immunostained with ProEx C.
Thirteen of 16 (81%) cases of HSIL stained positively with ProEx C. Two of 27 (7%) LSIL stained positively, and 2 (7%) cases of NILM stained positively. All 3 cases of SCC were strongly positive (100%). Staining for ProEx C showed a higher positive predictive value compared with p16.
ProEx C can be used on cell blocks prepared from residual liquid-based cervicovaginal cytologic specimens. Being a nuclear only stain, it is cleaner and easier to interpret even in scant specimens.
尽管液基宫颈阴道细胞学检查对检测发育异常/恶性病变具有较高的敏感性，但仍存在许多缺陷。细胞块可由剩余的液基宫颈阴道材料制备，并用于免疫组织化学。本研究的目的是评估一种新的标志物ProEx C在细胞块上的表现及其区分发育异常/恶性病变与形态异常但为良性细胞的能力。本研究结果与先前报道的同一材料上p16和Ki-67的结果进行了比较。
ProEx C是一种针对与异常S期细胞周期诱导相关蛋白质（拓扑异构酶IIA、微小染色体维持蛋白2）的单克隆抗体混合物。选择了79例患者的ThinPrep（Cytyc公司，马萨诸塞州博克斯伯勒）宫颈阴道标本。4例细胞块中无残留异常细胞。根据细胞块诊断，29例上皮内病变或恶性肿瘤为阴性（NILM），27例为低级别鳞状上皮内病变（LSIL），16例为高级别鳞状上皮内病变（HSIL），3例为鳞状细胞癌（SCC）。细胞块切片用ProEx C进行免疫染色。
16例HSIL中有13例（81%）ProEx C染色呈阳性。27例LSIL中有2例（7%）染色呈阳性，2例（7%）NILM染色呈阳性。所有3例SCC均呈强阳性（100%）。与p16相比，ProEx C染色显示出更高的阳性预测值。
ProEx C可用于由剩余液基宫颈阴道细胞学标本制备的细胞块。作为一种仅染细胞核的染色剂，即使在样本稀少的情况下，它也更清晰且易于解读。
