Histologic and immunophenotypic classification of cervical carcinomas by expression of the p53 homologue p63:: A study of 250 cases
Histologic and immunophenotypic classification of cervical carcinomas by expression of the p53 homologue p63:: A study of 250 cases
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DOI：
10.1053/hupa.2001.24324
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发表时间：
2001-05-01
期刊：
影响因子：
3.3
通讯作者：
Crum, CP
中科院分区：
文献类型：
--
作者：
Wang, TY;Chen, BF;Crum, CP
最近对p53同源物p63的研究表明，该基因优先在基底和未成熟的宫颈鳞状上皮中表达。本研究将p63表达与多种宫颈肿瘤的形态学表型和人乳头瘤病毒（HPV）类型相关联。250例宫颈癌包括鳞状细胞癌（SCCA; n = 178）、腺癌（ADCA; n = 28）、腺鳞癌（ASCA; n = 8）、神经内分泌癌（NECA; n = 15）和其他变异型或混合型（n = 21）。97%的SCCA、0%的ADCA和0%的SCUC显示p63强阳性（> 75% nu < 30%）（P <0.001）。p63可明显区分SCCA（p63+）和ADCA（p63-）。根据p63染色，大细胞低分化癌可被区分为假定的腺（玻璃样脱落）或鳞状淋巴上皮样或梭形细胞（梭形细胞）类型。11例神经内分泌肿瘤中有8例（73%）嗜铬粒蛋白阳性;所有肿瘤均无或低水平（< 30%）p63免疫染色。p63的缺失也与非神经内分泌未分化癌相关。从鳞状细胞到柱状细胞或未分化形态的转变与p63表达的丧失相吻合。HPV 16和p63阳性之间的强相关性被确定，因为两者在鳞状表型肿瘤内共定位。p63是鳞状分化的强有力的标记物，并且当扩散表达时，排除腺或神经内分泌分化。p63可用于区分纯鳞状或腺鳞状癌，跟踪肿瘤内分化的变化，支持（通过其缺失）神经内分泌癌的诊断，并澄清缺乏鳞状或神经内分泌分化的低分化癌的谱。Copyright（C）2001 by W.B.桑德斯公司
Recent studies of the p53 homologue p63 indicate that this gene is preferentially expressed in basal and immature cervical squamous epithelium. This study correlated p63 expression with morphologic phenotype and human papillomavirus (HPV) type in a wide range of cervical neoplasms. Two hundred fifty cases of cervical carcinoma, including squamous cell carcinoma (SCCA; n = 178), adenocarcinoma (ADCA; n = 28), adenosquamous carcinoma (ASCA; n = 8), neuroendocrine carcinoma (NECA; n = 15), and other variant or mixed types (n = 21) were studied. Ninety-seven percent of SCCA, 0% of ADCA and 0% of SCUC showed strong (> 75% nu < 30%) positivity for p63 (P < .001). p63 sharply distinguished SCCA (p63+) from ADCA (p63-), Large-cell, poorly differentiated carcinomas were distinguished as putative glandular (glassy fell) or squamous lymphoepithelial-like or spindle cell) types based on p63 staining. Eight (73%) of 11 neuroendocrine tumors tested were chromogranin positive; all showed no or low (< 30%) levels of p63 immunostaining. Absence of p63 was also associated with a subset of nonneuroendocrine undifferentiated carcinomas. Transitions from squamous to columnar or undifferentiated morphology coincided with loss of p63 expression. A strong association between HPV 16 and p63 positivity was identified because of the colocalization of both within tumors of squamous phenotype. p63 is a powerful marker for squamous differentiation and, when diffusely expressed, excludes a glandular or neuroendocrine differentiation. p63 may be useful for differentiating pure squamous or glandular from adenosquamous carcinomas, tracking shifts in differentiation within tumors, supporting (by its absence) the diagnosis of neuroendocrine carcinomas, and clarifying the spectrum of poorly differentiated carcinomas lacking either squamous or neuroendocrine differentiation. Copyright (C) 2001 by W.B. Saunders Company.