Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Histopathology. 2013 Apr;62(5):778-87. doi: 10.1111/his.12084. Epub 2013 Feb 21.
Biopsies from the ampulla of Vater and the common bile duct often pose diagnostic challenges. The aim of this study was to investigate the expression patterns of HMGA1, HMGA2, β-catenin and p53 in biopsy specimens, in order to evaluate the potential diagnostic value of these proteins in differentiating adenocarcinoma from reactive atypia or adenoma.
Forty-eight biopsies (10 from the common bile duct and 38 from the ampulla) were selected for immunohistochemical studies; they included 14 cases of reactive atypia, 12 adenomas, and 22 adenocarcinomas. Expression of HMGA1 was seen in 21% of the reactive atypia cases, 42% of adenomas, and 91% of adenocarcinomas. HMGA2 was positive in 14% of reactive atypias, 42% of adenomas, and 86% of adenocarcinomas. The staining intensity of HMGA1 and HMGA2 was also significantly higher in adenocarcinomas than in adenomas or reactive atypias. Interestingly, coexpression of HMGA1 and HMGA2 was found in 86% of adenocarcinomas, 0% of reactive atypias, and 8% of adenomas. p53 and β-catenin expression seemed not to provide additional value for discriminating adenocarcinoma from reactive atypia or adenoma.
HMGA1 and HMGA2 might serve to discriminate between reactive atypia, adenoma and adenocarcinoma in ampulla and common bile duct biopsies.
Vater 壶腹和胆总管的活检标本常常带来诊断上的挑战。本研究旨在探讨 HMGA1、HMGA2、β-连环蛋白和 p53 在活检标本中的表达模式，以评估这些蛋白在鉴别腺癌与反应性非典型增生或腺瘤中的潜在诊断价值。
选择 48 例活检标本（胆管 10 例，壶腹 38 例）进行免疫组织化学研究；包括反应性非典型增生 14 例、腺瘤 12 例和腺癌 22 例。HMGA1 在 21%的反应性非典型增生病例、42%的腺瘤和 91%的腺癌中表达。HMGA2 在 14%的反应性非典型增生病例、42%的腺瘤和 86%的腺癌中阳性。HMGA1 和 HMGA2 的染色强度在腺癌中也明显高于腺瘤或反应性非典型增生。有趣的是，86%的腺癌中存在 HMGA1 和 HMGA2 的共表达，0%的反应性非典型增生和 8%的腺瘤中存在 HMGA1 和 HMGA2 的共表达。p53 和 β-连环蛋白的表达似乎对鉴别腺癌与反应性非典型增生或腺瘤没有额外的价值。
HMGA1 和 HMGA2 可能有助于鉴别壶腹和胆总管活检标本中的反应性非典型增生、腺瘤和腺癌。
