PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to explore the efficacy of immunocytochemistry in diagnosing abdominopelvic washings (APWs) and evaluate the superiority of cytology combined with immunocytochemistry over cytology alone.
UNASSIGNED: Data on APW cytology and available cell blocks from patients who underwent radical surgery for endometrial cancer between January 2021 and December 2022 were reviewed. Cytology was re-evaluated according to a five-tier system. Immunocytochemistry analysis for targets such as Sry box transcription factor 1(SOX17), Paired box gene 2 (Pax-2) protein, Phosphatase and tensin (PTEN), and β-catenin was performed on each case with non-negative cytology. Mismatch repair (MMR) protein and P53 immunocytochemistry analyses were performed using cell blocks from cases with abnormal MMR or P53 expression in their primary lesion. The accuracies of cytology combined with immunocytochemistry and cytology alone were calculated.
UNASSIGNED: Overall, 126 patients were included in this study, 18 of whom demonstrated non-negative cytology of APW. Cell blocks were successfully prepared for 16 cases. SOX17 positivity was observed in 16 cases, including 1 of serous carcinoma, 1 of clear cell carcinoma, and 14 of endometrioid carcinoma (EC). Loss of Pax-2 and PTEN expression was observed in the APWs of the 14 patients with EC. MMR deficiency was noted in two patients with EC, and P53 mutation was noted in another two patients with EC. Compared with 10 metastatic carcinomas (10/18, 55.56%) diagnosed by cytology alone, 15 malignant APWs (15/18, 83.33%) were confirmed through combination cytology and immunocytochemistry. APWs were more likely to be observed in cases with more than half myometrial invasion than those with no or less than half myometrial invasion (P = 0.0067). The probability of malignant APW occurrence was slightly elevated in cases of EC exhibiting microcystic, elongated, and fragmented(MELF) infiltrative growth (P = 0.039).
UNASSIGNED: SOX17 is a useful Müllerian marker for distinguishing endometrial epithelium in APW. Loss of Pax-2 and PTEN expression offers evidence of metastatic endometrial carcinoma. Furthermore, positive APWs retained molecular features similar to primary lesions. The use of multiple immunocytochemical markers can effectively enhance the diagnostic efficiency of APWs.
UNASSIGNED: Data on APW cytology and available cell blocks from patients who underwent radical surgery for endometrial cancer between January 2021 and December 2022 were reviewed. Cytology was re-evaluated according to a five-tier system. Immunocytochemistry analysis for targets such as Sry box transcription factor 1(SOX17), Paired box gene 2 (Pax-2) protein, Phosphatase and tensin (PTEN), and β-catenin was performed on each case with non-negative cytology. Mismatch repair (MMR) protein and P53 immunocytochemistry analyses were performed using cell blocks from cases with abnormal MMR or P53 expression in their primary lesion. The accuracies of cytology combined with immunocytochemistry and cytology alone were calculated.
UNASSIGNED: Overall, 126 patients were included in this study, 18 of whom demonstrated non-negative cytology of APW. Cell blocks were successfully prepared for 16 cases. SOX17 positivity was observed in 16 cases, including 1 of serous carcinoma, 1 of clear cell carcinoma, and 14 of endometrioid carcinoma (EC). Loss of Pax-2 and PTEN expression was observed in the APWs of the 14 patients with EC. MMR deficiency was noted in two patients with EC, and P53 mutation was noted in another two patients with EC. Compared with 10 metastatic carcinomas (10/18, 55.56%) diagnosed by cytology alone, 15 malignant APWs (15/18, 83.33%) were confirmed through combination cytology and immunocytochemistry. APWs were more likely to be observed in cases with more than half myometrial invasion than those with no or less than half myometrial invasion (P = 0.0067). The probability of malignant APW occurrence was slightly elevated in cases of EC exhibiting microcystic, elongated, and fragmented(MELF) infiltrative growth (P = 0.039).
UNASSIGNED: SOX17 is a useful Müllerian marker for distinguishing endometrial epithelium in APW. Loss of Pax-2 and PTEN expression offers evidence of metastatic endometrial carcinoma. Furthermore, positive APWs retained molecular features similar to primary lesions. The use of multiple immunocytochemical markers can effectively enhance the diagnostic efficiency of APWs.
摘要：
■本研究旨在探讨免疫细胞化学在诊断腹肾盂冲洗液（APW）中的功效，并评估细胞学联合免疫细胞化学优于单独的细胞学。
■回顾了2021年1月至2022年12月期间接受子宫内膜癌根治性手术的患者的APW细胞学数据和可用细胞块。根据五层系统重新评估细胞学。针对Sry盒转录因子1（SOX17）等靶标的免疫细胞化学分析，配对盒基因2(Pax-2)蛋白,磷酸酶和张力蛋白（PTEN），和β-catenin在非阴性细胞学的每一个病例。使用来自原发性病变中MMR或P53表达异常的病例的细胞块进行错配修复（MMR）蛋白和P53免疫细胞化学分析。计算了细胞学结合免疫细胞化学和单独细胞学的准确性。
■总的来说，本研究包括126名患者，其中18例显示APW细胞学检查为非阴性。16例成功制备细胞块。SOX17阳性16例,包括1个浆液性癌，1透明细胞癌，和14子宫内膜样癌（EC）。在14例EC患者的APW中观察到Pax-2和PTEN表达的丧失。在两名EC患者中发现MMR缺乏，在另外两名EC患者中发现了P53突变。与仅通过细胞学诊断的10例转移癌（10/18，55.56％）相比，通过细胞学和免疫细胞化学联合证实了15例恶性APW（15/18，83.33％）。与没有或少于一半的子宫肌层浸润的患者相比，在超过一半的子宫肌层浸润的患者中更有可能观察到APW（P=0.0067）。在表现为微囊性EC的情况下，恶性APW发生的可能性略有升高，细长的，和片段化(MELF)浸润性生长(P=0.039)。
■SOX17是用于区分APW中子宫内膜上皮的有用的Müller标记物。Pax-2和PTEN表达的缺失提供了转移性子宫内膜癌的证据。此外，阳性APW保留了与原发性病变相似的分子特征。多种免疫细胞化学标记物的使用可有效提高APWs的诊断效率。
■回顾了2021年1月至2022年12月期间接受子宫内膜癌根治性手术的患者的APW细胞学数据和可用细胞块。根据五层系统重新评估细胞学。针对Sry盒转录因子1（SOX17）等靶标的免疫细胞化学分析，配对盒基因2(Pax-2)蛋白,磷酸酶和张力蛋白（PTEN），和β-catenin在非阴性细胞学的每一个病例。使用来自原发性病变中MMR或P53表达异常的病例的细胞块进行错配修复（MMR）蛋白和P53免疫细胞化学分析。计算了细胞学结合免疫细胞化学和单独细胞学的准确性。
■总的来说，本研究包括126名患者，其中18例显示APW细胞学检查为非阴性。16例成功制备细胞块。SOX17阳性16例,包括1个浆液性癌，1透明细胞癌，和14子宫内膜样癌（EC）。在14例EC患者的APW中观察到Pax-2和PTEN表达的丧失。在两名EC患者中发现MMR缺乏，在另外两名EC患者中发现了P53突变。与仅通过细胞学诊断的10例转移癌（10/18，55.56％）相比，通过细胞学和免疫细胞化学联合证实了15例恶性APW（15/18，83.33％）。与没有或少于一半的子宫肌层浸润的患者相比，在超过一半的子宫肌层浸润的患者中更有可能观察到APW（P=0.0067）。在表现为微囊性EC的情况下，恶性APW发生的可能性略有升高，细长的，和片段化(MELF)浸润性生长(P=0.039)。
■SOX17是用于区分APW中子宫内膜上皮的有用的Müller标记物。Pax-2和PTEN表达的缺失提供了转移性子宫内膜癌的证据。此外，阳性APW保留了与原发性病变相似的分子特征。多种免疫细胞化学标记物的使用可有效提高APWs的诊断效率。
