Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California 90095-1732, USA.
Cancer Cytopathol. 2013 Jun;121(6):320-8. doi: 10.1002/cncy.21264. Epub 2013 Jan 30.
ProEx C is an antibody cocktail targeting the expression of topoisomerase IIα and minichromosome maintenance protein-2. ProEx C staining is being used to assist in diagnoses of the gynecological specimens. This study was designed to determine the utility of ProEx C in urine cytology samples for improving the detection of urothelial carcinomas where a significant number of urine cytology specimens are diagnosed as "atypia."
Sixty urinary specimens (12 negative, 13 positive, and 35 atypical cases) were stained with ProEx C, and ProEx C results were recorded as positive when nuclear staining was only seen in at least one morphologically atypical urothelial cell.
All 12 benign cytology samples showed negative staining with ProEx C. Twelve of 13 cases that had a malignant cytologic diagnosis showed a positive nuclear staining of the malignant cells. Eighteen of 35 cases with atypical cytologic diagnoses showed positive nuclear staining. Of the 35 cases with "atypia," 17 had a malignant histopathologic follow-up. In this study, ProEx C stain had an overall sensitivity of 78.4%, specificity of 95.7%%, positive predictive value of 96.7%, and negative predictive value of 73.3% for the detection of urothelial carcinoma.
ProEx C stain is a useful adjunct test to urine cytologic analysis, even in specimens with limited cellularity. In urinary smears, this test is most useful in stratification of the "atypical" diagnoses into benign and malignant subsets. To the authors' knowledge, this is the first study of ProEx C application in urine cytology as an adjunct marker for detection of urothelial carcinoma.
ProEx C 是一种针对拓扑异构酶 IIα 和微小染色体维持蛋白-2 表达的抗体鸡尾酒。ProEx C 染色被用于辅助妇科标本的诊断。本研究旨在确定 ProEx C 在尿细胞学样本中的应用，以提高对尿路上皮癌的检测，其中相当数量的尿细胞学标本被诊断为“非典型”。
60 例尿标本（12 例阴性、13 例阳性和 35 例非典型病例）用 ProEx C 染色，当至少一个形态学上非典型的尿路上皮细胞中仅观察到核染色时，ProEx C 结果记录为阳性。
所有 12 例良性细胞学样本的 ProEx C 染色均为阴性。13 例恶性细胞学诊断中有 12 例显示恶性细胞的核染色阳性。35 例非典型细胞学诊断中有 18 例显示核染色阳性。在 35 例“非典型”病例中，有 17 例有恶性组织病理学随访。在本研究中，ProEx C 染色对尿路上皮癌的检测具有总体敏感性为 78.4%、特异性为 95.7%、阳性预测值为 96.7%和阴性预测值为 73.3%。
ProEx C 染色是尿细胞学分析的有用辅助试验，即使在细胞数量有限的标本中也是如此。在尿涂片上，该试验在将“非典型”诊断分层为良性和恶性亚组方面最有用。据作者所知，这是首次将 ProEx C 应用于尿细胞学作为检测尿路上皮癌的辅助标志物的研究。
