Cagle P T, Brown R W, Lebovitz R M
Department of Pathology, Baylor College of Medicine, Houston, TX 77030.
Hum Pathol. 1994 May;25(5):443-8. doi: 10.1016/0046-8177(94)90115-5.
To determine the utility of positive p53 protein immunostaining as an adjunct in the diagnosis of malignancy in pleural biopsy specimens, we reviewed 73 recently obtained pleural biopsy specimens that represented the typical range of diagnoses encountered in the evaluation of a proliferative pleural process. Immunohistochemistry was performed on paraffin sections of each biopsy specimen using a monoclonal antibody to the p53 suppressor gene product clone BP53-12 (BioGenex, San Ramon, CA) and a standard capillary gap (Microprobe, Fischer Scientific, Pittsburgh, PA) avidin-biotin complex technique with a citrate buffer antigen retrieval solution. Of the pleural biopsy specimens with unequivocal malignancy, 19 of 40 mesotheliomas and nine of 18 metastatic adenocarcinomas were immunopositive for p53 protein. All 13 of the biopsy specimens with reactive mesothelial hyperplasia or organizing pleuritis were negative. Two pleural biopsy specimens, which were interpreted as suspicious but inconclusive for malignancy, were positive for p53 protein and subsequent pathology specimens confirmed the presence of metastatic carcinoma in both of these biopsy specimens. Our findings suggest that p53 protein immunostaining is relatively sensitive and highly specific in differentiating reactive processes from primary or metastatic malignancies in histopathologically equivocal pleural biopsy specimens.
为了确定p53蛋白免疫染色在胸膜活检标本恶性肿瘤诊断中的辅助作用，我们回顾了73份近期获取的胸膜活检标本，这些标本代表了在评估增生性胸膜病变过程中遇到的典型诊断范围。使用针对p53抑癌基因产物克隆BP53 - 12（BioGenex，加利福尼亚州圣拉蒙）的单克隆抗体以及标准的毛细管间隙（Microprobe，宾夕法尼亚州匹兹堡市费希尔科学公司）抗生物素蛋白 - 生物素复合物技术和柠檬酸盐缓冲液抗原修复溶液，对每个活检标本的石蜡切片进行免疫组织化学检测。在明确为恶性的胸膜活检标本中，40例间皮瘤中有19例以及18例转移性腺癌中有9例p53蛋白免疫阳性。所有13例有反应性间皮细胞增生或机化性胸膜炎的活检标本均为阴性。两份被解释为可疑但恶性诊断不明确的胸膜活检标本p53蛋白呈阳性，随后的病理标本证实这两份活检标本均存在转移性癌。我们的研究结果表明，在组织病理学上难以明确的胸膜活检标本中，p53蛋白免疫染色在区分反应性病变与原发性或转移性恶性肿瘤方面相对敏感且特异性高。
