PDF(Pubmed)
Abstract：
OBJECTIVE: Gastric cancer and its precancerous lesions represent a significant public health concern. A subset of gastric cancers exhibits mutations in the TP53 gene, often accompanying distinctive morphologic alterations. This study aimed to assess the diagnostic efficacy of p53 immunostaining in real-world clinical settings.
METHODS: A retrospective analysis was conducted on 50 cases of gastric tumors and tumor-like lesions, wherein p53 immunostaining played a pivotal diagnostic role. The staining pattern of p53 was examined in conjunction with clinicopathologic parameters.
RESULTS: Mutant p53 staining pattern demonstrated a significant association with high-grade nuclear atypia (p<0.001), high-grade dysplasia, and tubular adenocarcinoma (p<0.001), as well as microsatellite instability status (p=0.034). Furthermore, the diagnostic utility of p53 immunostaining was evident in scenarios where: 1) biopsy specimens contained few tumor cells, 2) pathologic evaluation of resection margins was limited by cauterization artifacts, and 3) distinction between low-grade and high-grade gastric dysplasia was challenging.
CONCLUSIONS: P53 immunostaining can be helpful for the diagnosis of gastric tumor and tumor-like lesions, and accurate pathologic margin evaluation, particularly in lesions demonstrating intestinal-type differentiation and some degree of nuclear atypia.
METHODS: A retrospective analysis was conducted on 50 cases of gastric tumors and tumor-like lesions, wherein p53 immunostaining played a pivotal diagnostic role. The staining pattern of p53 was examined in conjunction with clinicopathologic parameters.
RESULTS: Mutant p53 staining pattern demonstrated a significant association with high-grade nuclear atypia (p<0.001), high-grade dysplasia, and tubular adenocarcinoma (p<0.001), as well as microsatellite instability status (p=0.034). Furthermore, the diagnostic utility of p53 immunostaining was evident in scenarios where: 1) biopsy specimens contained few tumor cells, 2) pathologic evaluation of resection margins was limited by cauterization artifacts, and 3) distinction between low-grade and high-grade gastric dysplasia was challenging.
CONCLUSIONS: P53 immunostaining can be helpful for the diagnosis of gastric tumor and tumor-like lesions, and accurate pathologic margin evaluation, particularly in lesions demonstrating intestinal-type differentiation and some degree of nuclear atypia.
摘要：
目的：胃癌及其癌前病变是一个重要的公共卫生问题。胃癌的一个子集表现出TP53基因的突变，通常伴随着独特的形态改变。本研究旨在评估p53免疫染色在现实世界临床环境中的诊断功效。
方法:回顾性分析50例胃肿瘤和肿瘤样病变,其中p53免疫染色起着关键的诊断作用。结合临床病理参数检查p53的染色模式。
结果：突变型p53染色模式显示与高级别核异型性显著相关（p<0.001），高度发育不良,和管状腺癌（p<0.001），以及微卫星不稳定状态（p=0.034）。此外，p53免疫染色的诊断效用在以下情况下很明显:1)活检标本含有很少的肿瘤细胞,2）切除边缘的病理评估受到烧灼伪影的限制，3）区分低度和高度胃发育不良具有挑战性。
结论：P53免疫染色有助于胃肿瘤和肿瘤样病变的诊断，和准确的病理边缘评估，特别是在显示肠型分化和一定程度的核异型的病变中。
方法:回顾性分析50例胃肿瘤和肿瘤样病变,其中p53免疫染色起着关键的诊断作用。结合临床病理参数检查p53的染色模式。
结果：突变型p53染色模式显示与高级别核异型性显著相关（p<0.001），高度发育不良,和管状腺癌（p<0.001），以及微卫星不稳定状态（p=0.034）。此外，p53免疫染色的诊断效用在以下情况下很明显:1)活检标本含有很少的肿瘤细胞,2）切除边缘的病理评估受到烧灼伪影的限制，3）区分低度和高度胃发育不良具有挑战性。
结论：P53免疫染色有助于胃肿瘤和肿瘤样病变的诊断，和准确的病理边缘评估，特别是在显示肠型分化和一定程度的核异型的病变中。
