Department of Pathology, Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Diagn Pathol. 2009 Oct 14;4:35. doi: 10.1186/1746-1596-4-35.
Distinction between non-neoplastic and neoplastic bladder lesions is therapeutically and prognostically important. Our objective is to describe the use of double immunohistochemistry (DIHC) for p53+CK20 as a tool for diagnosing neoplasia in bladder biopsies.
p53+CK20 DIHC were examined in 38 reactive atypia, 10 dysplasia, 9 carcinoma in situ (CIS) and 7 invasive carcinoma (IC) cases. CK20 was evaluated according to distribution extent and degree of intensity whereas percentage of positive cells together with staining intensity was taken into account in the evaluation of p53.
92% of reactive cases were either CK20(-) or (+) only in the upper 1/3 urothelium. In dysplastic cases CK20 staining distribution was as follows: 60% in 2/3 of the urothelium, 30% full thickness, 10% in the upper 1/3 urothelium. Among CIS cases, 89% had full thickness CK20 positivity, of which 62% were p53(+). 71% of IC cases exhibited strong and full thickness dual staining.
This is the first study in the literature to use DIHC of p53+CK20 in distinction of non-neoplastic and neoplastic bladder lesions. Dual staining by p53+CK20 cocktail allows for histologic correlation and diminishes the risk of losing the area of interest in limited biopsy specimens.
区分非肿瘤性和肿瘤性膀胱病变在治疗和预后方面都很重要。我们的目的是描述 p53+CK20 双重免疫组化（DIHC）在诊断膀胱活检中的肿瘤病变中的应用。
在 38 例反应性非典型性病变、10 例发育不良、9 例原位癌（CIS）和 7 例浸润性癌（IC）病例中检查了 p53+CK20 DIHC。根据 CK20 的分布范围和强度评估 CK20，而 p53 的评估则考虑阳性细胞的百分比和染色强度。
92%的反应性病例 CK20 仅在上 1/3 的尿路上皮中呈阴性或阳性。在发育不良病例中，CK20 的染色分布如下：60%在 2/3 的尿路上皮中，30%在全层，10%在上 1/3 的尿路上皮中。在 CIS 病例中，89%的病例全层 CK20 阳性，其中 62%为 p53（+）。71%的 IC 病例表现出强烈和全层双重染色。
这是文献中首次使用 p53+CK20 的 DIHC 来区分非肿瘤性和肿瘤性膀胱病变的研究。p53+CK20 鸡尾酒的双重染色允许进行组织学相关性，并减少在有限的活检标本中失去感兴趣区域的风险。
