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MDM2 荧光原位杂交确认的高分化和去分化脂肪肉瘤中 p16、MDM2 和 CDK4 的免疫组织化学表达的诊断准确性。

Diagnostic Accuracy of Immunohistochemical Expression of p16, MDM2, and CDK4 in Well-Differentiated and De-Differentiated Liposarcoma in MDM2 Fluorescent <em>in situ </em>Hybridisation Confirmed Cases.

机构信息

Department of Histopathology, Combined Military Hospital, Peshawar, Pakistan.

Department of Histopathology, Armed Forces Postgraduate Medical Institute, Rawalpindi, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2024 Sep;34(9):1051-1055. doi: 10.29271/jcpsp.2024.09.1051.


DOI:10.29271/jcpsp.2024.09.1051
PMID:39262004
Abstract

OBJECTIVE: 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. STUDY DESIGN: 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. METHODOLOGY: 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. RESULTS: 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. CONCLUSION: 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. KEY WORDS: De-differentiated liposarcoma, Well-differentiated liposarcoma, P16, CDK4, MDM2.

摘要

目的: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。

研究设计: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。

方法: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。

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%。

结论: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。

关键词:去分化型脂肪肉瘤、分化良好型脂肪肉瘤、p16、CDK4、MDM2。

相似文献

[1]
Diagnostic Accuracy of Immunohistochemical Expression of p16, MDM2, and CDK4 in Well-Differentiated and De-Differentiated Liposarcoma in MDM2 Fluorescent <em>in situ </em>Hybridisation Confirmed Cases.

J Coll Physicians Surg Pak. 2024-9

[2]
Differential diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma: utility of p16 in combination with MDM2 and CDK4 immunohistochemistry.

Hum Pathol. 2017-1

[3]
Diagnostic Utility and Limitations of Immunohistochemistry of p16, CDK4, and MDM2 and Automated Dual-color In Situ Hybridization of MDM2 for the Diagnosis of Challenging Cases of Dedifferentiated Liposarcoma.

Appl Immunohistochem Mol Morphol. 2019

[4]
Can MDM2 and CDK4 make the diagnosis of well differentiated/dedifferentiated liposarcoma? An immunohistochemical study on 129 soft tissue tumours.

J Clin Pathol. 2009-12

[5]
MDM2 and CDK4 immunostainings are useful adjuncts in diagnosing well-differentiated and dedifferentiated liposarcoma subtypes: a comparative analysis of 559 soft tissue neoplasms with genetic data.

Am J Surg Pathol. 2005-10

[6]
[Clinical value of fluorescence hybridization with and probe in diagnosis of liposarcoma].

Beijing Da Xue Xue Bao Yi Xue Ban. 2023-4-18

[7]
Detection of gene amplification on tissue microarray-based Fluorescence In-Situ Hybridization (FISH) in well-differentiated and dedifferentiated liposarcomas, displaying a wide morphological spectrum: A validation study at a tertiary cancer referral centre.

Indian J Pathol Microbiol. 2022

[8]
MDM2 and CDK4 Immunohistochemistry: Should It Be Used in Problematic Differentiated Lipomatous Tumors?: A New Perspective.

Am J Surg Pathol. 2016-12

[9]
Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors.

Am J Surg Pathol. 2012-3

[10]
Clinical and biological significance of CDK4 amplification in well-differentiated and dedifferentiated liposarcomas.

Clin Cancer Res. 2009-9-8

引用本文的文献

[1]
Deep Introspection Regarding Cumulative Prognostic Factors in Liposarcoma and Atypical Lipomatous Tumor.

Medicina (Kaunas). 2025-8-8

[2]
Real-world survival outcomes and MDM2 prevalence in US patients with metastatic dedifferentiated liposarcoma.

Future Oncol. 2025-6

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