S100P, von Hippel-Lindau gene product, and IMP3 serve as a useful immunohistochemical panel in the diagnosis of adenocarcinoma on endoscopic bile duct biopsy
S100P, von Hippel-Lindau gene product, and IMP3 serve as a useful immunohistochemical panel in the diagnosis of adenocarcinoma on endoscopic bile duct biopsy
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DOI：
10.1016/j.humpath.2010.01.014
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发表时间：
2010-09-01
期刊：
影响因子：
3.3
通讯作者：
Wang, Hanlin L.
中科院分区：
文献类型：
--
作者：
Levy, Mary;Lin, Fan;Wang, Hanlin L.
由于材料有限、挤压伪影和复合炎症和/或反应性变化（尤其是支架置入后），内镜活检中良性和恶性胆管上皮病变的组织学区分极具挑战性。本研究应用免疫组化方法检测了40例胆管腺癌和32例胆管良性病变中S100 P、pVHL和IMP 3的表达，以评价其诊断价值。结果表明，36例（90%）腺癌细胞核和胞浆S100 P均呈强阳性，其中30例（83.3%）呈弥漫性阳性。在31个肿瘤（77.5%）（15个弥漫性，16个局灶性）中证实了IMP 3的中等至强细胞质染色。在37例腺癌中观察到pVHL完全阴性染色。在其余3个肿瘤中，检测到局灶性（1）或弥漫性（2）膜和细胞质pVHL免疫反应性。28例肿瘤（70%）显示S100 P +/IMP 3 +/pVHL-染色模式，6例（15%）显示S100 P +/IMP 3-/pVHL-模式，2例（5%）显示S100 P-/IMP 3 +/pVHL-模式。所有32例良性活检均为IMP 3完全阴性，2例局灶性不典型增生除外，其中观察到局灶性免疫反应性。30例（93.8%）良性病变组织中pVHL呈阳性，28例（93.3%）呈弥漫性染色。8例（25%）良性病变组织中S100 P灶性表达。22例（68.8%）良性肿瘤组织中S100 P-/IMP 3-/pVHL+染色。总之，由S100 P、pVHL和IMP3组成的免疫组化组可以帮助区分腺癌和挑战性胆管活检的反应性上皮变化。局灶性S100 P和/或IMP3表达与pVHL免疫反应性的相互损失在一些良性活检的结果表明，使用这些标志物在检测早期上皮异型增生，可能超出组织学识别。(C)2010年爱思唯尔公司All rights reserved.
Histopathologic distinction between benign and malignant bile duct epithelial lesions on endoscopic biopsies can be extremely challenging because of limited material, crush artifact, and compounding inflammatory and/or reactive changes particularly after stent placement. In this study, a total of 72 endoscopic bile duct biopsies, including 40 adenocarcinomas and 32 benign cases, were immunohistochemically examined for the expression of S100P, von Hippel-Lindau gene product (pVHL), and IMP3 to evaluate their diagnostic value. The results showed that 36 adenocarcinomas (90%) exhibited strong nuclear and cytoplasmic staining for S100P, of which 30 (83.3%) showed diffuse immunoreactivity. Intermediate to strong cytoplasmic staining for IMP3 was demonstrated in 31 tumors (77.5%) (15 diffuse, 16 focal). Completely negative staining for pVHL was observed in 37 adenocarcinomas. In the remaining 3 tumors, focal (1) or diffuse (2) membranous and cytoplasmic pVHL immunoreactivity was detected. Twenty-eight tumors (70%) showed a S100P+/IMP3+/pVHL- staining pattern, 6 (15%) with a S100P+/IMP3-/pVHL- pattern, and 2 (5%) with a S100P-/IMP3+/pVHL- pattern. All 32 benign biopsies were completely negative for IMP3 with the exception of 2 cases with focal dysplasia where focal immunoreactivity was observed. Thirty benign biopsies (93.8%) were positive for pVHL with a diffuse staining pattern observed in 28 cases (93.3%). Eight benign biopsies (25%) showed focal S100P positivity. Twenty-two benign biopsies (68.8%) displayed a S100P-/IMP3-/pVHL+ staining pattern. In conclusion, an immunohistochemical panel consisting of S100P, pVHL, and IMP3 can be helpful in distinguishing adenocarcinoma from reactive epithelial changes on challenging bile duct biopsies. The findings of focal S100P and/or IMP3 expression with reciprocal loss of pVHL immunoreactivity in a few benign biopsies suggest a use of these markers in the detection of early epithelial dysplasia that may be beyond histologic recognition. (C) 2010 Elsevier Inc. All rights reserved.