Department of Histopathology, Combined Military Hospital, Peshawar, Pakistan.
Department of Histopathology, Armed Forces Postgraduate Medical Institute, Rawalpindi, Pakistan.
J Coll Physicians Surg Pak. 2024 Sep;34(9):1051-1055. doi: 10.29271/jcpsp.2024.09.1051.
To establish the diagnostic utility of immunohistochemistry markers p16 along with MDM2 and CDK-4 in confirming the diagnosis of well-differentiated and de-differentiated liposarcoma while taking Fluorescent in situ Hybridisation (FISH) as a gold standard.
A cross-sectional study. Place and Duration of the Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from 30th January 2022 to 30th June 2023.
A standard panel of three immunohistochemistry markers p16, MDM2, and CDK4 were applied to 36 cases of atypical lipomatous tumours, well-differentiated liposarcoma (WDLPS), and de-differentiated liposarcoma (DDLPS), on which the gold standard FISH was already performed. The sample size was calculated with the help of a WHO calculator taking prevalence 1-2% in Pakistani population. Qualitative variables such as gender and site of tumour were presented by calculating frequency and percentages and comparison of Immunohistochemistry results with FISH was done by using a 2x2 table.
The sensitivity and specificity of this triple marker panel for detecting WDLPS/DDLPS were 43.47% and 15.38%, respectively. The sensitivity and specificity of CDK4 for detecting WDLPS / DDLPS were 82.6% and 15.4%, those of MDM2 were 73.9% and 61.5 %, and those of p16 were 60.9% and 53.8%, respectively.
Among all three markers, CDK4 was the most sensitive and MDM2 was the most specific marker for detecting WDLPS-DDLPS. It also showed that a combination of these three markers improves the diagnostic credibility of the immunohistochemistry in diagnosing DDLPS and WDLPS but FISH is the most reliable and confirmatory method.
De-differentiated liposarcoma, Well-differentiated liposarcoma, P16, CDK4, MDM2.
通过荧光原位杂交（FISH）作为金标准，确定免疫组织化学标志物 p16 与 MDM2 和 CDK4 联合用于确认分化良好型和去分化型脂肪肉瘤的诊断效用。
一项横断面研究。研究地点和时间：巴基斯坦拉瓦尔品第武装部队病理学研究所组织病理学系，2022 年 1 月 30 日至 2023 年 6 月 30 日。
对 36 例非典型脂肪瘤性肿瘤、分化良好型脂肪肉瘤（WDLPS）和去分化型脂肪肉瘤（DDLPS）应用 p16、MDM2 和 CDK4 三种免疫组织化学标志物的标准面板，这些病例已经进行了 FISH 金标准检测。使用世界卫生组织计算器根据巴基斯坦人群的患病率 1-2%计算样本量。通过计算频率和百分比来呈现性别和肿瘤部位等定性变量，并使用 2x2 表比较免疫组织化学结果与 FISH 的结果。
该三联标志物面板用于检测 WDLPS/DDLPS 的灵敏度和特异性分别为 43.47%和 15.38%。CDK4 检测 WDLPS/DDLPS 的灵敏度和特异性分别为 82.6%和 15.4%，MDM2 分别为 73.9%和 61.5%，p16 分别为 60.9%和 53.8%。
在这三种标志物中，CDK4 是检测 WDLPS-DDLPS 最敏感的标志物，MDM2 是最特异的标志物。它还表明，这三种标志物的联合使用可以提高免疫组织化学诊断 DDLPS 和 WDLPS 的可信度，但 FISH 是最可靠和确证的方法。
去分化型脂肪肉瘤、分化良好型脂肪肉瘤、p16、CDK4、MDM2。
