Περίληψη:
Objectives. To investigate whether combining a semi-quantitative scoring
method with the immunohistochemical expression of CEA, MIB-1 and p 16,
would improve the diagnostic accuracy of endocervical glandular lesions.
Methods. The hematoxylin and eosin-stained sections of 95 cervical
biopsies were examined by 4 different observers and were grouped into
three categories, benign, dysplasia and adenocarcinoma in situ,
depending on the degree of nuclear stratification, nuclear atypia and
the number of mitosis and apoptotic figures. Each case was also stained
immunohistochemically with antibodies against CEA, Ki-67 (MIB-1) and
p16. Staining was graded as negative, weak and positive. The accuracy of
the scoring method alone was compared to the accuracy of combining the
score with the immunostaining results.
Results. Using the semi-quantitative scoring system, most of the cases
that were initially diagnosed as atypical hyperplasia or tuboendometrial
metaplasia fell into the benign category. This scoring system
discriminates effectively (Kruskal-Wall is, p < 0.001) between the three
categories (benign, endocervical glandular dysplasia and adenocarcinoma
in situ). When analyzing the immunohistochemical score, only Ki-67
staining seems to be effective mostly in discriminating between normal
glands or glands with atypical hyperplasia and epithelial glandular
dysplasia. Ki-67, CEA and p16 failed to discriminate between
tuboendometrial metaplasia and epithelial glandular dysplasia. Combining
the semi-quantitative scoring system with the immunohistochemical
results discriminates between the three categories equally well as the
semi-quantitative scoring system alone (Kruskal-Wallis, p < 0.001).
Nevertheless, the proportion of cases that were classified similarly to
the prestudy diagnosis was higher when the combined score was used.
Conclusions. Combining a semi-quantitative scoring scheme with the
immunohistochemical expression of CEA, MIB-1 and p16seems to be of value
in classifying some endocervical glandular lesions. (c) 2006 Elsevier
Inc. All rights reserved.
Συγγραφείς:
Pavlakis, K.
Messini, I.
Athanassiadou, S.
Kyrodimou, E. and
Pandazopoulou, A.
Vrekoussis, Th.
Stathopoulos, E. N.
