非典型免疫组化模式可辅助口腔癌前病变的组织病理学诊断。

Atypical immunohistochemical patterns can complement the histopathological diagnosis of oral premalignant lesions.

作者信息

Ikeda Mikihito, Shima Kaori, Kondo Tomoyuki, Semba Ichiro

机构信息

Department of Oral Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka 8-35-1, Kagoshima 890-8544, Japan.

出版信息

J Oral Biosci. 2020 Mar;62(1):93-98. doi: 10.1016/j.job.2020.01.003. Epub 2020 Jan 31.

DOI:10.1016/j.job.2020.01.003

PMID:32014614

Abstract

BACKGROUND

The histopathological diagnosis of oral premalignant lesions (OPLs) such as oral epithelial dysplasia (ED) and carcinoma in situ (CIS), as well as epithelial hyperplasia (EHP), is important for the early detection and precise treatment of oral squamous cell carcinoma. However, the standardization of detection and treatment by histological criteria alone remains challenging owing to the complicated and varied histology. We evaluated practically useful immunohistochemical (IHC) markers that might complement the histopathological diagnosis of OPLs.

METHODS

We re-evaluated the histopathological diagnoses and IHC patterns of Ki-67, TP53, CK13, and CK17 in 200 cases of OPLs and performed multiple logistic regression analyses for their predictive accuracy.

RESULTS

We identified and compared atypical IHC patterns in OPLs and in the normal epithelium. Ki-67 expression showed specific patterns in categorized OPLs as EHP, low-grade dysplasia (LED), high-grade dysplasia (HED), and CIS. Multiple logistic regression analyses in the quadrant categories revealed that EHP and CIS had high predictive accuracies of 90.1% and 96.2%, respectively, and in binary categories, combined EHP and LED versus combined HED and CIS showed predictive accuracies of 92.1% and 89.9%, respectively. Binominal logistic regression analysis between each quadrant category revealed satisfactory predictive accuracy of EHP vs. LED, LED vs. HED, and HED vs. CIS (75.2%, 78.9%, and 87.9%, respectively), and Ki-67 showed the highest adjusted odds ratio, followed by TP53.

CONCLUSION

The proposed atypical IHC patterns might serve as useful markers to supplement the morphological diagnosis of OPLs, and established IHC methods for Ki-67 and TP53 might provide stable results.

摘要

背景

口腔上皮异常增生（ED）、原位癌（CIS）以及上皮增生（EHP）等口腔癌前病变（OPL）的组织病理学诊断，对于口腔鳞状细胞癌的早期发现和精准治疗至关重要。然而，仅依靠组织学标准进行检测和治疗的标准化仍具有挑战性，因为其组织学复杂多样。我们评估了可能补充OPL组织病理学诊断的实用免疫组织化学（IHC）标志物。

方法

我们重新评估了200例OPL中Ki-67、TP53、CK13和CK17的组织病理学诊断及IHC模式，并对其预测准确性进行了多元逻辑回归分析。

结果

我们识别并比较了OPL和正常上皮中的非典型IHC模式。Ki-67表达在分类为EHP、低级别上皮内瘤变（LED）、高级别上皮内瘤变（HED）和CIS的OPL中呈现特定模式。象限分类中的多元逻辑回归分析显示，EHP和CIS的预测准确性较高，分别为90.1%和96.2%，在二元分类中，EHP和LED组合与HED和CIS组合的预测准确性分别为92.1%和89.9%。各象限分类之间的二项逻辑回归分析显示，EHP与LED、LED与HED、HED与CIS的预测准确性令人满意（分别为75.2%、78.9%和87.9%），Ki-67的调整优势比最高，其次是TP53。