Best Practices in Diagnostic lmmunohistochemistry Myoepithelial Markers in Breast Pathology
Best Practices in Diagnostic lmmunohistochemistry Myoepithelial Markers in Breast Pathology
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DOI：
10.1043/2010-0336-cp.1
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发表时间：
2011-04-01
影响因子：
4.6
通讯作者：
Gown, Allen M.
中科院分区：
文献类型：
--
作者：
Dewar, Rajan;Fadare, Oluwole;Gown, Allen M.
背景。-许多免疫组织化学染色已被证明在乳腺肌上皮细胞中相对于其管腔/上皮对应物表现出排他性或优先阳性。这些肌上皮标志物提供了宝贵的援助，准确分类乳腺增生，特别是在核心活检。尽管有许多肌上皮标志物可用，但它们在灵敏度、特异性和解释的容易性方面不同，这在很大程度上可能归因于这些标志物在基质细胞（包括肌成纤维细胞、血管、管腔/上皮细胞和肿瘤细胞）中的可变免疫反应性。回顾乳腺病理学中常用的肌上皮标志物，并选择它们可能有用的诊断方案。数据来源。这篇综述文章中概述的信息是基于我们对常规病例的经验和对1987年至2008年期间发表的英语文章的回顾。为了证明肌上皮细胞的存在或不存在，建议使用2种或更多种标记物的基于组的方法。最有效地结合联合收割机灵敏度、特异性和易于解释的标志物包括平滑肌肌球蛋白重链、钙调蛋白、p75、p63、P-钙粘蛋白、基底细胞角蛋白、maspin和CD 10。然而，这些标志物，显示不同的交叉反应模式，并在肌上皮细胞交界处原位癌的表达减少。肌上皮标志物的选择应取决于多种因素的组合，包括已发表的关于其诊断实用性的证据、其可用性、在给定实验室中已实现的性能特征以及具体的诊断方案。当它的使用被认为是必要的，免疫组化的肌上皮细胞在乳腺病理学是最有效的概念时，作为补充，而不是中央的常规形态学解释。(Arch Pathol Lab Med. 2011;135：422-429）
Context.-Numerous immunohistochemical stains have been shown to exhibit exclusive or preferential positivity in breast myoepithelial cells relative to their luminal/epithelial counterparts. These myoepithelial markers provide invaluable assistance in accurately classifying breast proliferations, especially in core biopsies. Although numerous myoepithelial markers are available, they differ in their sensitivity, specificity, and ease of interpretation, which may be attributed, to a large extent, to the variable immunoreactivity of these markers in stromal cells including myofibroblasts, vessels, luminal/epithelial cells, and tumor cells.Objective.-To review commonly used myoepithelial markers in breast pathology and a selection of diagnostic scenarios where they may be useful.Data Sources.-The information outlined in this review article is based on our experiences with routine cases and a review of English-language articles published between 1987 and 2008.Conclusions.-To demonstrate the presence or absence of myoepithelial cells, a panel-based approach of 2 or more markers is recommended. Markers that most effectively combine sensitivity, specificity, and ease of interpretation include smooth muscle myosin heavy chains, calponin, p75, p63, P-cadherin, basal cytokeratins, maspin, and CD10. These markers, however, display varying cross-reactivity patterns and variably reduced expression in the myoepithelial cells bordering in situ carcinomas. The choice of a myoepithelial marker should be dependent on a combination of factors, including published evidence on its diagnostic utility, its availability, performance characteristics that have been achieved in a given laboratory, and the specific diagnostic scenario. When its use is deemed necessary, immunohistochemistry for myoepithelial cells in breast pathology is most effective when conceptualized as supplemental, rather than central to routine morphologic interpretation. (Arch Pathol Lab Med. 2011;135:422-429)