Department of Pathology, China Medical University Hospital, and Department of Medical Imaging and Radiological Science, Chung-Shan Medical University, Taichung, Taiwan.
Arch Gynecol Obstet. 2010 Feb;281(2):293-300. doi: 10.1007/s00404-009-1094-0. Epub 2009 May 6.
Endocervical adenocarcinomas (ECAs) and endometrial adenocarcinomas (EMAs) are malignancies that affect the uterus; however, their biological behaviors are quite different. This distinction has clinical significance because the appropriate therapy may depend on the site of tumor origin. The purpose of this study is to evaluate two different scoring mechanisms of p16INK4a immunohistochemical (IHC) stain in distinguishing between primary ECAs and EMAs.
A tissue microarray (TMA) was constructed using formalin-fixed, paraffin-embedded tissue from hysterectomy specimens, including 14 ECAs and 21 EMAs. Tissue array sections were stained with a commercially available antibody, p16INK4a. The avidin-biotin complex method was used to visualize antigens. The staining intensity and extent of the IHC reactions were evaluated using a semi-quantitative scoring system. Two scoring methods were defined on the following bases: (1) independent cytoplasmic staining alone, irrespective of nucleic stain (Method C) and (2) independent nucleic staining alone, irrespective of cytoplasmic staining. (Method N).
Of the two scoring mechanisms for p16INK4a expression, Method N showed a significant difference (P=0.015), but Method C showed no significant (P=0.432) frequency differences in distinguishing between ECAs and EMAs. However, Method N had a higher overall accuracy rate (71.4%) in accurately diagnosing ECAs from EMAs in the total number of p16INK4a IHC cases.
According to the data of p16(INK4a) expression in this TMA study, Method N is favorable and efficient in distinguishing between ECAs and EMAs, while Method C is not.
宫颈腺癌（ECAs）和子宫内膜腺癌（EMAs）是影响子宫的恶性肿瘤；然而，它们的生物学行为有很大的不同。这种区别具有临床意义，因为适当的治疗可能取决于肿瘤起源部位。本研究的目的是评估两种不同的 p16INK4a 免疫组织化学（IHC）染色评分机制在鉴别原发性 ECAs 和 EMAs 中的作用。
使用来自子宫切除术标本的福尔马林固定、石蜡包埋组织构建组织微阵列（TMA），包括 14 例 ECAs 和 21 例 EMAs。组织阵列切片用商业可得的 p16INK4a 抗体染色。使用亲和素-生物素复合物法显示抗原。使用半定量评分系统评估 IHC 反应的染色强度和范围。根据以下基础定义了两种评分方法：（1）独立的细胞质染色，不论核染色如何（方法 C）和（2）独立的核染色，不论细胞质染色如何（方法 N）。
在 p16INK4a 表达的两种评分机制中，方法 N 显示出显著差异（P=0.015），但方法 C 在区分 ECAs 和 EMAs 方面没有显示出显著的（P=0.432）频率差异。然而，方法 N 在总 p16INK4a IHC 病例中对准确诊断 ECAs 来自 EMAs 的总体准确率（71.4%）更高。
根据本 TMA 研究中 p16（INK4a）表达的数据，方法 N 在区分 ECAs 和 EMAs 方面是有利且高效的，而方法 C 则不然。
