在肺非小细胞癌的细胞学诊断中，p40（多克隆抗体）能否替代p63（克隆4A4）？
Can p40 (Polyclonal) Replace p63 (Clone 4A4) in the Cytologic Diagnosis of Pulmonary Non-Small Cell Carcinoma?
作者信息
Alexander Melissa, Chiaffarano Jeanine, Zhou Fang, Cangiarella Joan, Yee-Chang Melissa, Simsir Aylin
机构信息
From New York University Langone Medical Center, New York, NY.
出版信息
Am J Clin Pathol. 2017 Jun 1;147(6):580-588. doi: 10.1093/ajcp/aqx031.
OBJECTIVES
Differentiating squamous cell carcinoma from adenocarcinoma (ACA) in cytology specimens can be challenging. Recent literature showed p40 had higher specificity than p63 for this purpose.
METHODS
We identified 190 cytology cases with p40 (polyclonal) and p63 (monoclonal clone 4A4) immunohistochemistry, including specimens from fine-needle aspirations (FNAs) and effusions.
RESULTS
ACAs of lung origin stained for p40 and p63 in 21% and 20% of cases, respectively, regardless of specimen site. Among lung FNAs of primary pulmonary ACAs (n = 42), 14% were positive for p40 and 24% were positive for p63. Of the 20 pulmonary ACAs in effusions, more cases showed p40 positivity (40%) compared with FNAs, whereas p63 were positive in 15%. Among metastatic ACAs from other sites (n = 14), more cases were positive for p40 than p63.
CONCLUSIONS
Polyclonal p40 yields a level of false positivity in ACAs similar to p63, which is highest in effusions and is not limited to lung origin.
目的
在细胞学标本中鉴别鳞状细胞癌与腺癌具有挑战性。近期文献表明，在此方面p40的特异性高于p63。
方法
我们对190例进行了p40（多克隆）和p63（单克隆克隆4A4）免疫组织化学检测的细胞学病例进行了分析，包括细针穿刺抽吸活检（FNA）标本和积液标本。
结果
无论标本来源部位如何，肺源性腺癌中分别有21%和20%的病例p40和p63染色呈阳性。在原发性肺腺癌的肺FNA标本（n = 42）中，14%的病例p40呈阳性，24%的病例p63呈阳性。在20例积液中的肺腺癌病例中，与FNA标本相比，更多病例p40呈阳性（40%），而p63呈阳性的病例为15%。在其他部位转移而来的腺癌（n = 14）中，p40呈阳性的病例多于p63呈阳性的病例。
结论
多克隆p40在腺癌中产生的假阳性水平与p63相似，在积液中最高，且不限于肺源性。
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