Kosmas Konstantinos, Stamoulas Marios, Marouga Anna, Kavantzas Nicolaos, Patsouris Efstratios, Athanassiadou Paulina
Department of Cytopathology, Anti-cancer Oncological Hospital St. Savvas, Athens, Greece.
Diagn Cytopathol. 2013 Mar;41(3):212-7. doi: 10.1002/dc.21825. Epub 2011 Sep 30.
The aims of this study were to determine the expression of Ki-67 in type I and type II endometrial adenocarcinomas as well as normal endometrium in imprint smears and to correlate the results with clinicopathologic parameters of primary untreated endometrial cancer patients. During a 29-month period, 255 patients were evaluated with entometrial imprint cytology. Endometrial samples freshly resected from women who underwent total abdominal hysterectomy were studied. One hundred twenty-six patients had endometrial carcinoma and 129 cases were diagnosed as normal endometrium. The expression of Ki-67 was assessed by immunocytochemistry. Positive staining was correlated with increased stage, grade and lymph node metastases. High expression was more frequent in type II than type I endometrial adenocarcinoma and high-grade endometrial carcinoma had higher proportions of Ki-67 positive immunostaining compared with low-grade carcinoma. Proliferative endometrium showed high Ki-67 expression level, even higher than those of grade 1 and type I. On the other hand, secretory endometrium Ki-67 positive cells were markedly diminished and even disappeared. Completely negative staining was found to be related to atrophic endometrium. Immunocytochemical findings from Ki-67 stain, in addition to cytomorphologic features, appeared to be useful for the diagnosis of endometrial carcinoma in endometrial cytology with imprint smears. High Ki-67 expression correlates with morphologic features of aggressiveness and the expression pattern of Ki-67 correspond to the expected cyclic/atrophic pattern in normal endometrium.
本研究的目的是确定Ki-67在印片涂片中I型和II型子宫内膜腺癌以及正常子宫内膜中的表达情况，并将结果与未经治疗的原发性子宫内膜癌患者的临床病理参数相关联。在29个月的时间里，对255例患者进行了子宫内膜印片细胞学评估。研究了从接受全腹子宫切除术的女性新鲜切除的子宫内膜样本。126例患者患有子宫内膜癌，129例被诊断为正常子宫内膜。通过免疫细胞化学评估Ki-67的表达。阳性染色与分期增加、分级升高和淋巴结转移相关。II型子宫内膜腺癌中高表达比I型更常见，与低级别癌相比，高级别子宫内膜癌中Ki-67阳性免疫染色的比例更高。增殖期子宫内膜显示出高Ki-67表达水平，甚至高于1级和I型。另一方面，分泌期子宫内膜Ki-67阳性细胞明显减少甚至消失。发现完全阴性染色与萎缩性子宫内膜有关。除细胞形态学特征外，Ki-67染色的免疫细胞化学结果似乎有助于通过印片涂片诊断子宫内膜细胞学中的子宫内膜癌。高Ki-67表达与侵袭性的形态学特征相关，且Ki-67的表达模式与正常子宫内膜中预期的周期性/萎缩性模式相对应。
