Diagnostic value of smoothelin and vimentin in differentiating muscularis propria from muscularis mucosa of bladder carcinoma
Diagnostic value of smoothelin and vimentin in differentiating muscularis propria from muscularis mucosa of bladder carcinoma
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DOI：
10.5301/jbm.5000252
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发表时间：
2017-07-01
影响因子：
2
通讯作者：
Ghanem, Noha
中科院分区：
文献类型：
--
作者：
Elkady, Noha;Abdou, Asmaa Gaber;Ghanem, Noha
背景：确定浸润程度或病理分期是对膀胱癌标本进行充分评估的必要条件之一。因此，鉴别多发性脊髓瘤和多发性脊髓瘤对于正确治疗和避免分期过高或过低至关重要。目的：探讨平滑蛋白（smoothelin）和波形蛋白（vimentin）单独及联合表达对MM和MP的鉴别诊断价值。方法：对59例原发性膀胱癌膀胱切除术标本和11例非肿瘤性膀胱病变（膀胱炎）膀胱镜活检标本进行研究。结果：组织学上40例MM清晰，70例MP均可见。免疫染色检测光滑蛋白和波形蛋白。平滑素表达强度在MM和MP之间有显著差异（P = 0.001），敏感性为97.5%，特异性为95%；平滑素在MP中的表达比例显著高于MM (P = 0.001)，敏感性为95.7%，特异性为85%（以65%为截止点）。Vimentin在MP中呈阴性，在32例（80%）MM中呈阳性表达，差异有统计学意义（P = 0.001），敏感性为80%，特异性为100%。结合中强平滑蛋白和阴性波形蛋白，对MP的鉴定具有100%的敏感性和100%的特异性。结论：根据组织病理学标准可以区分MM和MP，不幸的是，在许多情况下，组织病理学标准重叠。中度至强烈的平滑蛋白表达伴vimentin阴性对困难和重叠病例的诊断非常有帮助，诊断有效性高。
Background: Determination of the extent of involvement or pathological staging is one of the requirements for adequate evaluation of bladder cancer specimens. Therefore, the differentiation between MP and MM is essential for proper treatment and avoiding over or under staging.Aim: The present study aimed at evaluation of diagnostic value of smoothelin and vimentin expression both singly and in combination for differentiation between MM and MP.Methods: This study was carried out on 59 cystectomy specimens of primary bladder carcinoma and eleven cystoscopic biopsies for non-neoplastic bladder lesions (cystitis).Results: Histologically, MM was identified clearly in 40 cases and MP was identified in all 70 examined cases. The cases were immunostained for smoothelin and vimentin. Intensity of smoothelin expression showed significant difference (P = 0.001) between MM and MP with 97.5% sensitivity and 95% specificity and the percentage of smoothelin expression was significantly higher in MP compared to MM (P = 0.001) with 95.7% sensitivity and 85% specificity (using 65% as cut-off point). Vimentin was negative in MP and showed positive expression in 32 cases (80%) of MM with a statistical significant difference (P = 0.001) providing 80% sensitivity and 100% specificity. Combined moderate to strong smoothelin and negative vimentin offered 100% sensitivity and 100% specificity towards the identification of MP.Conclusions: Differentiation of MM from MP can be made based on histopathological criteria, which are unfortunately overlapping in many cases. Moderate to strong smoothelin expression with negative vimentin could be very helpful procedure in difficult and overlapping cases with a high diagnostic validity.