Laminin-5 immunocytochemistry: a new tool for identifying dysplastic cells in oral brush biopsies
Laminin-5 immunocytochemistry: a new tool for identifying dysplastic cells in oral brush biopsies
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DOI：
10.1111/j.1365-2303.2006.00401.x
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发表时间：
2007-12-01
期刊：
影响因子：
1.3
通讯作者：
Kosmehl, H.
中科院分区：
文献类型：
--
作者：
Driemel, O.;Dahse, R.;Kosmehl, H.
刷检技术不仅是一项开创性的技术，而且是一种被广泛讨论的检测口腔癌前病变和明显癌的方法。层粘连蛋白-5的伽马2链及其蛋白分解片段构成了许多癌症的侵袭因子。本研究的目的是确定层粘连蛋白伽马2链的免疫细胞化学呈现是否识别刷检中的侵袭前或侵袭性鳞状细胞。标准化免疫细胞化学：抗层粘连蛋白-γ2链的单抗：D4B5、4G1，用ChemMate和自动染色检测。常规细胞学未发现任何假阳性病例，即正常、炎症或良性过度增殖的粘膜中的非典型细胞(特异性，100%)，而免疫细胞化学显示1例假阳性(特异性，98%)。在口腔鳞癌的刷检中，免疫细胞化学模式如下：(1)胞浆染色，(2)成团的癌细胞之间有条带状的斑纹，(3)非典型细胞周围有阳性的雾状物。细菌菌落出现假阳性结果。27例癌中有4例和3例复发中有1例未经细胞学鉴定(常规细胞学的敏感性为79%)。5例细胞学未明确诊断的癌中，3例用层粘连蛋白γ2链抗体进行免疫细胞化学染色(层粘连蛋白γ2链免疫细胞化学敏感性为93%)。常规细胞学阳性预测值为100%，层粘连蛋白-γ2链免疫细胞化学阳性预测值为97%。常规细胞学的阴性预测值为92%，层粘连蛋白γ2链免疫细胞化学的阴性预测值为97%。方法增强刷检细胞学的高敏感性提示该技术可作为初步诊断步骤。
The brush biopsy technique is not only a seminal technique but also a critically discussed method for detection of oral pre-cancerous stages and manifest carcinomas. The gamma 2 chain of laminin-5 and its proteolytic fragments comprise an invasion factor for many carcinomas.The aim of this study was to determine whether the immunocytochemical presentation of the laminin gamma 2 chain identifies pre-invasive or invasive squamous cells in brush biopsies.The value-based identification of atypical epithelia was analysed in 93 consecutive brush biopsies with histopathological diagnoses: standardized haematoxylin and eosin staining; standardized immunocytochemistry: monoclonal antibodies against laminin gamma 2 chain: D4B5, 4G1, detection using ChemMate and Autostainer.Conventional cytology did not result in any false-positive cases, i.e. atypical cells in normal, inflamed or benignly hyperproliferative mucosa (specificity, 100%), whereas immunocytochemistry revealed one false-positive case (specificity, 98%). In brush biopsies of oral squamous cell carcinomas, the following immunocytochemical patterns were possible: (1) staining of the cytoplasm, (2) banded markings between clumped carcinoma cells and (3) positive hazes surrounding atypical cells. Bacterial colonies appeared as false-positive results. Four of 27 carcinomas and one of three recurrences were not cytologically identified (sensitivity of conventional cytology, 79%). Three of the five carcinomas not identified by cytology were immunocytochemically stained with laminin gamma 2 chain antibody (sensitivity of laminin gamma 2 chain immunocytochemistry, 93%). The positive predictive value was 100% for conventional cytology and 97% for laminin gamma 2 chain immunocytochemistry. The negative predictive value attained was 92% for conventional cytology and 97% for laminin gamma 2 chain immunocytochemistry.The high sensitivity level observed for method-enhanced brush cytology suggests that this technique be used as an initial diagnostic step.