van Hoeven K H, Ramondetta L, Kovatich A J, Bibbo M, Dunton C J
Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Int J Gynecol Pathol. 1997 Jan;16(1):15-21. doi: 10.1097/00004347-199701000-00003.
The diagnosis of endocervical neoplasia can be difficult as it is sometimes mimicked by proliferative or reactive glands. MIB-1 is a proliferation marker that can aid in the diagnosis of squamous intraepithelial lesions (SIL) of the cervix and vulva, but its potential value in the diagnosis of endocervical lesions has not been fully explored. Ten formalin-fixed, paraffin-embedded cases of each of the following were obtained: morphologically normal endocervical glands from patients with cervical SIL, endocervicitis, microglandular hyperplasia (MGH), and endocervical adenocarcinomas (eight in situ, two invasive). Microwave unmasking of antigens was performed prior to immunohistochemical staining for MIB-1 using the avidin/biotin peroxidase method. Labeling indexes were calculated for 34 specimens (10 adenocarcinoma. 8 each of the other diagnoses) using image analysis (Samba 4000). There was diffuse MIB-1 reactivity in adenocarcinoma (labeling index 57-96%, mean 80%), minimal focal reactivity in normal glands underlying SIL (labeling index 0.8-4.3%, mean 2.4%), moderate spotty reactivity in MGH (labeling index 2.9-18.4%, mean 8.5%), and minimal to focally diffuse reactivity in endocervicitis (labeling index 1.0-13.3%, mean 5.7%). These data indicate that the percentage and distribution of MIB-1-reactive endocervical cells can be of diagnostic utility in distinguishing neoplastic glands from those of endocervicitis and MGH.
宫颈管内瘤变的诊断可能具有挑战性，因为它有时会被增殖性或反应性腺体所模仿。MIB-1是一种增殖标志物，可有助于诊断宫颈和外阴的鳞状上皮内病变（SIL），但其在宫颈管内病变诊断中的潜在价值尚未得到充分探索。我们获取了以下每种情况的10例经福尔马林固定、石蜡包埋的病例：宫颈SIL患者形态学正常的宫颈管腺体、宫颈炎、微小腺体增生（MGH）以及宫颈管腺癌（8例原位癌，2例浸润癌）。在使用抗生物素蛋白/生物素过氧化物酶法对MIB-1进行免疫组织化学染色之前，先进行抗原微波解封处理。使用图像分析（Samba 4000）对34个标本（10例腺癌，其他诊断各8例）计算标记指数。腺癌中存在弥漫性MIB-1反应性（标记指数57%-96%，平均80%），SIL下方正常腺体中有最小程度的局灶性反应性（标记指数0.8%-4.3%，平均2.4%），MGH中有中度散在反应性（标记指数2.9%-18.4%，平均8.5%），宫颈炎中有最小程度至局灶性弥漫性反应性（标记指数1.0%-13.3%，平均5.7%）。这些数据表明，MIB-1反应性宫颈管细胞的百分比和分布在区分肿瘤性腺体与宫颈炎和MGH的腺体方面具有诊断效用。
