Selection of endometrial carcinomas for p53 immunohistochemistry based on nuclear features.
Selection of endometrial carcinomas for p53 immunohistochemistry based on nuclear features.
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DOI：
10.1002/cjp2.243
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Köbel M
中科院分区：
文献类型：
--
作者：
Kang EY;Wiebe NJ;Aubrey C;Lee CH;Anglesio MS;Tilley D;Ghatage P;Nelson GS;Lee S;Köbel M
世界卫生组织认可子宫内膜分子亚分类子宫内膜样癌（EECs）。我们的目的是测试肿瘤形态学在捕获p53异常（p53abn）病例中的敏感性，并模拟p53abn对ESGO/ESTRO/ESP（欧洲妇科肿瘤学会/欧洲放射与肿瘤学会/欧洲病理学会）风险分层变化的影响。在加拿大卡尔加里的Foothills医疗中心（2019-2021）接受的292例连续子宫内膜癌切除术被检索并分配到有和没有p53状态的ESGO风险组。三位病理学家回顾了具有代表性的H&E染色切片，预测了p53的状态，并指示是否需要进行p53免疫组化（IHC）。艾伯塔省2008-2016年诊断的子宫内膜癌的基于人群的生存率来自艾伯塔省癌症登记处。该队列主要由1/2级子宫内膜样癌（EEC1/2; N = 218, 74.6%）组成。152例EEC1/2（52.1%）为IA期，147例（50.3%）为ESGO低风险。p53abn和亚克隆p53的总体患病率分别为14.5%和8.3%。观察者预测p53abn的平均灵敏度为83.6%。观察者要求p53免疫组化检测p53abn的灵敏度为39.4%,98.5%（99.6%的阴性预测值）。核特征包括染色质模糊、多形性、非典型有丝分裂和肿瘤巨细胞能准确预测p53abn。在7/292（2.4%）中，p53abn将ESGO风险组升级（2个为中等风险，5个为高风险）。EEC1/2/ IA期患者的疾病特异性5年生存率为98.5%。病理学家可以选择灵敏度高、假阴性风险低的病例进行p53检测。子宫内膜癌的分子特征有很大的潜力来完善一小部分子宫内膜癌的ESGO风险分类，但对大约一半的子宫内膜癌，即EEC1/2/ IA期病例几乎没有价值。
The World Health Organization endorses molecular subclassification of endometrial endometrioid carcinomas (EECs). Our objectives were to test the sensitivity of tumor morphology in capturing p53 abnormal (p53abn) cases and to model the impact of p53abn on changes to ESGO/ESTRO/ESP (European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology) risk stratification. A total of 292 consecutive endometrial carcinoma resections received at Foothills Medical Centre, Calgary, Canada (2019–2021) were retrieved and assigned to ESGO risk groups with and without p53 status. Three pathologists reviewed the representative H&E‐stained slides, predicted the p53 status, and indicated whether p53 immunohistochemistry (IHC) would be ordered. Population‐based survival for endometrial carcinomas diagnosed during 2008–2016 in Alberta was obtained from the Alberta Cancer Registry. The cohort consisted mostly of grade 1/2 endometrioid carcinomas (EEC1/2; N = 218, 74.6%). One hundred and fifty‐two EEC1/2 (52.1% overall) were stage IA and 147 (50.3%) were low risk by ESGO. The overall prevalence of p53abn and subclonal p53 was 14.5 and 8.3%, respectively. The average sensitivity of predicting p53abn among observers was 83.6%. Observers requested p53 IHC for 39.4% with 98.5% sensitivity to detect p53abn (99.6% negative predictive value). Nuclear features including smudged chromatin, pleomorphism, atypical mitoses, and tumor giant cells accurately predicted p53abn. In 7/292 (2.4%), p53abn upgraded ESGO risk groups (2 to intermediate risk, 5 to high risk). EEC1/2/stage IA patients had an excellent disease‐specific 5‐year survival of 98.5%. Pathologists can select cases for p53 testing with high sensitivity and low risk of false negativity. Molecular characterization of endometrial carcinomas has great potential to refine ESGO risk classification for a small subset but offers little value for approximately half of endometrial carcinomas, namely, EEC1/2/stage IA cases.
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DOI：
10.1097/pgp.0000000000000674
发表时间：
2021-03-01
影响因子：
2.4
作者：
Brett, Mary Anne;Atenafu, Eshetu G.;Kobel, Martin
通讯作者：
Kobel, Martin