Tiniakos D G, Healicon R M, Hair T, Wadehra V, Horne C H, Angus B
University Department of Pathology, Royal Victoria Infirmary, U.K.
Acta Cytol. 1995 Mar-Apr;39(2):171-6.
The accurate identification of suspicious cells in cytologic preparations is a common problem in diagnostic cytopathology. Recent studies have shown that mutation of the p53 gene may be the most common genetic event in human malignancy. Mutation leads to altered conformation and increased half-life of the p53 protein, resulting in detectability by immunocytochemistry. The usefulness of p53 immunocytochemical staining as a marker of malignancy in the cytologic analysis of body fluids was investigated in the present study. One hundred fifty-four serial samples of body fluids submitted for cytologic diagnosis were also examined for p53 immunoreactivity. Of 121 cases reported as cytologically benign, 3 (2.5%) stained positively for p53; 16 samples were cytologically malignant, and 7 (43.7%) of these were positive for p53 (P < .001). Of those reported as suspicious but not conclusively malignant, 4 of 17 (23.5%) showed p53 immunoreactivity. On review, two of the three patients whose samples were benign cytologically yet showed positive p53 staining had histologic evidence of malignancy. The third patient died without a postmortem examination. Of the 17 cytologically suspicious cases, 16 (94.1%) were later proven to be malignant, and p53 was positive in 4 (25%). These results suggest that p53 immunostaining could be of value as a marker of malignancy in the cytologic examination of body fluids. The presence of p53 immunoreactivity in cytologic samples is strongly suggestive of malignancy, though its absence does not exclude neoplasia.
在细胞病理学诊断中，准确识别细胞涂片制剂中的可疑细胞是一个常见问题。最近的研究表明，p53基因的突变可能是人类恶性肿瘤中最常见的基因事件。突变导致p53蛋白的构象改变和半衰期延长，从而可通过免疫细胞化学检测到。本研究探讨了p53免疫细胞化学染色作为体液细胞分析中恶性肿瘤标志物的实用性。对提交进行细胞诊断的154份连续体液样本也进行了p53免疫反应性检测。在报告为细胞良性的121例病例中，3例（2.5%）p53染色呈阳性；16份样本为细胞恶性，其中7例（43.7%）p53呈阳性（P <.001）。在报告为可疑但未确诊为恶性的病例中，17例中有4例（23.5%）显示p53免疫反应性。复查发现，样本细胞良性但p53染色呈阳性的3例患者中，有2例有恶性肿瘤的组织学证据。第三例患者未进行尸检死亡。在17例细胞学可疑病例中，16例（94.1%）后来被证实为恶性，4例（25%）p53呈阳性。这些结果表明，p53免疫染色作为体液细胞检查中恶性肿瘤的标志物可能具有价值。细胞样本中p53免疫反应性的存在强烈提示恶性肿瘤，但其不存在并不排除肿瘤形成。
