P63在胸腺瘤亚型诊断中的作用

Role of P63expression in diagnosis of thymoma subtypes

目的探讨胸腺瘤各亚型中P63的表达及其在病理诊断中的意义。方法收集76例胸腺上皮肿瘤(TET;包括胸腺瘤及胸腺癌)标本,应用免疫组化技术(SP法)检测P63在TET各亚型中的表达。同时对比分析初始诊断、复核诊断及参考P63表达诊断3组结果。结果复核诊断发现9例误诊,主要集中在胸腺瘤AB型和B型,还有3例不能确诊。P63不同程度阳性表达于72例TET中,定位于肿瘤细胞核,并在不同TET亚型中呈现不同形态和分布特点。参考P63表达结果的病理诊断的准确率优于未参考P63的初始病理诊断的准确率(TET:P=0.017;胸腺瘤:P=0.032)。结合P63的表达帮助确诊了复诊中不能明确的3例胸腺瘤亚型。结论鉴于结合P63表达能更好地区分胸腺瘤各亚型,我们建议在临床病理诊断中将其作为常规标记物,尤其在诊断胸腺瘤AB型和B型时。

Objective To study the expression of P63 in 76 patients with thymic epithelial tumors （TET, including thymomas and thymic carcinomas） and its role in pathological diagnosis of TET based on World Health Organization classification. Methods Immunohistochemistry （SP method） was used to detect P63 expression in 76 different subtypes of TET tissues. The initial diagnostic results, further diagnosis results and diagnostic results considering P63 expression were analyzed and compared. Results The further diagnosis results identified 9 cases of misdiagnosis （mainly AB and B subtypes） and 3 uncertain cases. Different degrees of P63 expression （located in the nuclei） was observed in 72 cases, and different subtypes had different expression patterns. The diagnostic results considering P63 expression were more accurate than those not considering P63 expression （TET, P=0. 017 and thymoma, P= 0. 032, respectively）. Detection of P63 expression helped to confirm the diagnosis of the 3 uncertain cases according to the further diagnosis results. Conclusion Considering that P63 expression can help to better differentiate the subtypes of thymoma, it should be used as a routine marker for clinical diagnosis, especially for AB and B subtype thymoma.