Payne S, Kernohan N M, Walker F
Department of Pathology, University Medical Buildings, Aberdeen.
J Clin Pathol. 1996 Aug;49(8):667-71. doi: 10.1136/jcp.49.8.667.
To characterise further the proliferative compartment of the normal cervix and to document its alteration, if any, in the various grades of cervical intraepithelial neoplasia (CIN), particularly changes to the basal epithelial layer; to hypothesise as to the diagnostic and biological significance of any observed differences.
Proliferative compartments from 86 cervical biopsy specimens (10 normal, 11 with koilocytic change only, 12 CIN I, nine CIN II, and 44 CIN III) were determined using microwave antigen retrieval and a standard three-step Streptavidin biotin peroxidase immunocytochemical technique incorporating the MIB-1 monoclonal antibody (directed against the Ki-67 antigen). Immunoreactivity was assessed as occupying either the lower one third, lower two thirds or all three thirds of the squamous epithelium. Basal cell positivity was also quantitated.
Specimens without CIN showed a thin suprabasal proliferative compartment two to four cells thick. True basal positivity was infrequent. With increasing grade of CIN, the growth compartment stretched evermore superficially so that in lesions of CIN III almost the full thickness of epithelium was cycling. In all grades of CIN, basal cell proliferation was significantly increased.
In normal cervix, the parabasal layers represent the main proliferative pool with the basal layer providing a reserve. When CIN supervenes, this proliferative compartment expands commensurate with the grade of dysplasia and as basal turnover is increased specifically the intimate relation between epithelium and basement membrane might be disturbed, facilitating invasion. The diagnostic utility of these changes in growth compartments is limited.
进一步明确正常宫颈的增殖区，并记录其在不同级别的宫颈上皮内瘤变（CIN）中是否发生改变，尤其是基底上皮层的变化；推测所观察到的差异的诊断及生物学意义。
采用微波抗原修复法及标准三步链霉抗生物素蛋白 - 生物素过氧化物酶免疫细胞化学技术，结合MIB - 1单克隆抗体（针对Ki - 67抗原），测定86例宫颈活检标本（10例正常、11例仅有挖空细胞改变、12例CIN I、9例CIN II和44例CIN III）的增殖区。免疫反应性评估为鳞状上皮的下三分之一、下三分之二或全部三分之三区域出现反应。同时对基底细胞阳性情况进行定量分析。
无CIN的标本显示出薄的基底上层增殖区，厚度为2至4个细胞。真正的基底阳性很少见。随着CIN级别增加，生长区向上皮表面延伸得越来越多，以至于在CIN III病变中，几乎上皮全层都处于细胞周期。在所有级别的CIN中，基底细胞增殖均显著增加。
在正常宫颈中，副基底层是主要的增殖池，基底层提供储备。当CIN出现时，这个增殖区会随着发育异常的级别相应扩大，并且由于基底细胞更新增加，上皮与基底膜之间的紧密关系可能会受到干扰，从而促进侵袭。这些生长区变化的诊断效用有限。
