"To Be or Not to Be in a Good Shape": Diagnostic and Clinical Value of Nuclear Shape Irregularities in Thyroid and Breast Cancer
"To Be or Not to Be in a Good Shape": Diagnostic and Clinical Value of Nuclear Shape Irregularities in Thyroid and Breast Cancer
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DOI：
10.1007/978-1-4899-8032-8_5
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发表时间：
2014-01-01
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影响因子：
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通讯作者：
Marchio, Caterina
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作者：
Bussolati, Gianni;Maletta, Francesca;Marchio, Caterina
细胞核形状和大小的变化（“多形性”），加上染色质数量和分布的变化，仍然是显微镜下细胞学诊断癌症的基本标准。核形状不规则的生物学决定因素尚未澄清，因此，而不是对核不规则的起源，我们在这里把我们的注意力集中在核多形性的描述性分析。我们记住，目前在常规制备中进行的核形状评估是不适当的，因为它是间接基于DNA的分布，这是由碱性染料的亲和力所揭示的。因此，在过去的几年里，我们一直使用免疫荧光、原位杂交和3D重建来确定甲状腺和乳腺癌细胞核的形态学特征作为标准。我们已经翻译了这种方法的常规诊断病理组织切片上采用免疫过氧化物酶染色emerin。通过标记核膜蛋白（如层粘连蛋白B和emerin）来直接检测核膜的不规则性，可以更客观地定义细胞核的形状。在这篇综述中，我们详细讨论了方法问题以及甲状腺和乳腺癌核膜装饰/染色所提供的诊断和预后意义，从而证明了在处理癌症病理诊断时“形状正确”是多么重要。
Variation in both nuclear shape and size ("pleomorphism"), coupled with changes in chromatin amount and distribution, remains the basic criteria for microscopy in a cytologic diagnosis of cancer. The biological determinants of nuclear shape irregularities are not clarified, so, rather than on the genesis of nuclear irregularities, we here focus our attention on a descriptive analysis of nuclear pleomorphism. We keep in mind that evaluation of nuclear shape as currently practiced in routine preparations is improper because it is indirectly based on the distribution of DNA as revealed by the affinity for basic dyes. Therefore, over the last years we have been using as criteria morphological features of nuclei of thyroid and breast carcinomas as determined by immunofluorescence, in situ hybridization, and 3D reconstruction. We have translated this approach to routine diagnostic pathology on tissue sections by employing immunoperoxidase staining for emerin. Direct detection of nuclear envelope irregularities by tagging nuclear membrane proteins such as lamin B and emerin has resulted in a more objective definition of the shape of the nucleus. In this review we discuss in detail methodological issues as well as diagnostic and prognostic implications provided by decoration/staining of the nuclear envelope in both thyroid and breast cancer, thus demonstrating how much it matters "to be in the right shape" when dealing with pathological diagnosis of cancer.