Liao Chiung-Ling, Lee Ming-Yung, Tyan Yeu-Sheng, Kok Lai-Fong, Wu Tina S, Koo Chiew-Loon, Wang Po-Hui, Chao Kuan-Chong, Han Chih-Ping
Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taichung, Taiwan.
J Transl Med. 2009 May 28;7:37. doi: 10.1186/1479-5876-7-37.
Endocervical adenocarcinomas (ECA) and endometrial adenocarcinomas (EMA) are uterine malignancies that have differing biological behaviors. The choice of an appropriate therapeutic plan rests on the tumor's site of origin. In this study, we propose to evaluate whether PR adds value to the performance and test effectiveness of the conventional 3-marker (ER/Vim/CEA) panel in distinguishing between primary ECA and EMA.
A tissue microarray was constructed using paraffin-embedded, formalin-fixed tissues from 38 hysterectomy specimens, including 14 ECA and 24 EMA. Tissue microarray (TMA) sections were immunostained with 4 antibodies, using the avidin-biotin complex (ABC) method for antigen visualization. The staining intensity and extent of the immunohistochemical (IHC) reactions were appraised using a semi-quantitative scoring system.
The three markers (ER, Vim and CEA) and their respective panel expressions showed statistically significant (p < 0.05) frequency differences between ECA and EMA tumors. Although the additional ancillary PR-marker also revealed a significant frequency difference (p < 0.05) between ECA and EMA tumors, it did not demonstrate any supplementary benefit to the 3-marker panel.
According to our data, when histomorphological and clinical doubt exists as to the primary site of origin, we recommend that the conventional 3-marker (ER/Vim/CEA) panel is easier, sufficient and appropriate to use in distinguishing between primary ECA and EMA. Although the 4-marker panel containing PR also reveals statistically significant results, the PR-marker offers no supplemental benefit to the pre-existing 3-marker (ER/Vim/CEA) panel in the diagnostic distinction between ECA and EMA.
宫颈内膜腺癌（ECA）和子宫内膜腺癌（EMA）是具有不同生物学行为的子宫恶性肿瘤。合适治疗方案的选择取决于肿瘤的起源部位。在本研究中，我们旨在评估孕激素受体（PR）是否能增强传统三标志物（雌激素受体/波形蛋白/癌胚抗原，ER/Vim/CEA）组合在鉴别原发性ECA和EMA方面的性能及检测有效性。
使用来自38例子宫切除标本（包括14例ECA和24例EMA）的石蜡包埋、福尔马林固定组织构建组织微阵列。组织微阵列（TMA）切片用4种抗体进行免疫染色，采用抗生物素蛋白-生物素复合物（ABC）法进行抗原可视化。使用半定量评分系统评估免疫组织化学（IHC）反应的染色强度和范围。
三种标志物（ER、Vim和CEA）及其各自的组合表达在ECA和EMA肿瘤之间显示出统计学上的显著（p < 0.05）频率差异。尽管额外的辅助PR标志物在ECA和EMA肿瘤之间也显示出显著的频率差异（p < 0.05），但它并未显示出对三标志物组合有任何补充益处。
根据我们的数据，当对原发性起源部位存在组织形态学和临床疑问时，我们建议传统的三标志物（ER/Vim/CEA）组合在鉴别原发性ECA和EMA时使用起来更简便、足够且合适。尽管包含PR的四标志物组合也显示出统计学上的显著结果，但PR标志物在ECA和EMA的诊断鉴别中对现有的三标志物（ER/Vim/CEA）组合没有提供补充益处。
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