Differential expression of immunohistochemical markers in bladder smooth muscle and myofibroblasts, and the potential utility of desmin, smoothelin, and vimentin in staging of bladder carcinoma
Differential expression of immunohistochemical markers in bladder smooth muscle and myofibroblasts, and the potential utility of desmin, smoothelin, and vimentin in staging of bladder carcinoma
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DOI：
10.1038/modpathol.2009.9
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发表时间：
2009-05-01
期刊：
影响因子：
7.5
通讯作者：
Hameed, Omar
中科院分区：
文献类型：
--
作者：
Council, Leona;Hameed, Omar
区分膀胱固有肌层和粘膜肌层是有问题的，特别是在膀胱癌经尿道切除标本时。此外，膀胱癌可能与增殖性/结缔组织增殖性肌成纤维细胞反应相关，这种反应类似于平滑肌，可能导致固有肌层侵犯的过度诊断。本研究的目的是通过评估15例浸润性膀胱癌中肌成纤维细胞和非血管平滑肌细胞中不同标志物的表达，探讨免疫组织化学在膀胱癌分期中的潜在作用。反应性肌成纤维细胞始终呈波形蛋白和平滑肌肌动蛋白阳性，caldesmon、desmin和smooth - thelin始终呈阴性，并且actin和CD10的表达变化。膀胱非血管平滑肌细胞的平滑肌肌动蛋白、肌动蛋白、desmin和caldesmon持续呈阳性，CD10持续呈阴性。15例固有肌层平滑肌细胞均表现出较强的smooththelin表达，而11例粘膜肌层平滑肌细胞中只有1例（9%）表现出中度的smooththelin表达（P = 10(-7)）。令人惊讶的是，尽管内皮细胞和肌内膜细胞强烈表达，但15例固有肌层平滑肌细胞中只有1例（7%）弱表达vimentin，而11例粘膜肌层平滑肌细胞中有9例（82%）中等或强表达（P = 0.00016）。desmin或caldesmon在平滑肌细胞表达的敏感性和特异性均为100%。平滑蛋白强表达对固有肌层的敏感性为100%，而波形蛋白不表达对固有肌层的敏感性为93%，特异性为82%。尽管形态学仍然是金标准，但研究结果表明，免疫组织化学，使用由去丝蛋白、光滑蛋白和静脉蛋白组成的小组，可能对膀胱癌的分期有潜在的帮助。更大规模的确证性研究，特别是经尿道切除标本，是有必要的。现代病理学（2009）22,639-650；doi: 10.1038 / modpathol.2009.9;2009年2月27日在线发布
Distinguishing bladder muscularis propria from muscularis mucosae can be problematic especially in transurethral resection specimens performed for bladder carcinoma. Moreover, bladder carcinoma can be associated with a proliferative/desmoplastic myofibroblastic response that can resemble smooth muscle and potentially lead to overdiagnosis of muscularis propria invasion. The aim of this study was to investigate the potential role of immunohistochemistry in staging bladder carcinoma by evaluating the expression of different markers in myofibroblasts and nonvascular smooth muscle cells in 15 cases of invasive bladder carcinoma. Reactive myofibroblasts were consistently positive for vimentin and smooth muscle actin, consistently negative for caldesmon, desmin, and smoothelin, and had variable expression of actin and CD10. Nonvascular smooth muscle cells of the bladder were consistently positive for smooth muscle actin, actin, desmin, and caldesmon, and consistently negative for CD10. In contrast to smooth muscle cells of the muscularis propria, which displayed strong smoothelin expression in all 15 cases, the smooth muscle cells of the muscularis mucosae displayed moderate smoothelin expression in only 1 (9%) of 11 cases (P = 10(-7)). Surprisingly, although strongly highlighting endothelial and endomysial cells, the smooth muscle cells of the muscularis propria weakly expressed vimentin in only 1 (7%) of 15 cases, whereas smooth muscle cells of the muscularis mucosae had moderate or strong expression in 9 (82%) of 11 cases (P = 0.00016). The sensitivity and specificity of desmin or caldesmon expression for smooth muscle cells were 100%. The sensitivity and specificity of strong smoothelin expression for muscularis propria were 100%, whereas those of absent vimentin expression were 93 and 82%, respectively. Although morphology remains the gold standard, the findings suggest that immunohistochemistry, using a panel composed of desmin, smoothelin, and vimentin, may be potentially useful for staging of bladder carcinoma. Confirmatory larger-scale studies, especially on transurethral resection specimens, are warranted. Modern Pathology (2009) 22, 639-650; doi: 10.1038/modpathol.2009.9; published online 27 February 2009