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ASCUS 시 ThinPrepTMsmear에서 biomarker로서의 p16INK4A의 과발현
여소진,이권해,남계현,심일구,김태희,김형문,조희정,권계연 대한부인종양학회 2005 Journal of Gynecologic Oncology Vol.16 No.2
Objective : The overexpression of p16INK4A is induced by human papillomavirus (HPV) and associated with the carcinogenesis of cervical epithelia. So, immunostaining of p16INK4A may be useful biomarker in detecting CIN of cervix uteri in abnormal cervical lesions. The potential of p16INK4A as a biomarker for Atypical squamous cells of undetermined significance (ASCUS) examined in liquid-based specimens. Methods : We collected samples 30 cases of ASCUS in ThinprepTM smears between March 2003 and August 2003. 23 control ThinprepTM cases were included; 10 negative for intraepithelial lesions, 13 cervical squamous intraepithelial lesions. p16INK4A immunochemial staining was performed on 53samples. At the same time, we tested another cervical swabs of patients by the Hybrid Capture ⅡTM test. The cut off value was scored positive if it contained above 5 abnormal cells with nuclear and cytoplasmic immunostaining. Results : The results of p16INK4A immunochemial staining comparing with one of HCⅡTM showed negative results with low kappa coefficient of 0.034. The sensitivity of p16INK4A immunochemial staining were 30.8% and the specificity were 82.4% respectively (p<0.01). p16INK4A is a useful marker for the detection of the cervical intraepithelial neoplasia but is not ASCUS. Conclusion : Immunostaining of p16INK4A is not useful triage test in detecting abnormal lesion of ASCUS in liquid-based specimens. 목적 : p16INK4A은 인유두종 바이러스 감염 시 과다 발현되어 자궁 경부 이형성증 및 암의 유용한 표지자로 대두되고 있다. ThinPrepTM 도말 검사를 시행한 환자 중 Atypical squamous cells of undetermined significance(이하 ASCUS)로 나온 환자에서 p16INK4A의 biomarker로서 유용성을 알아보기 위하여 연구했다. 연구 방법 : 2003년 3월부터 8월까지 ThinPrepTM 도말 검사를 시행한 환자 중 ASCUS로 나온 30명의 환자와 대조군으로 23명(Negative for intraepithelial lesion: 10명, low grade squamous intraepithelial lesions(이하 LSIL) 이상 나온 13명)의 환자를 포함 총 53명을 대상으로 하였다. ThinPrepTM 도말검사의 검체를 이용하여 p16 면역화학염색을 시행했고, 동시에 Hybrid CaptureⅡTM(이하 HCⅡ)검사를 하였다. 이 연구에서 양성은 최소한 5개 이상의 세포에서 핵과 세포질에 염색된 경우로 하였다. 결과 : ASCUS시 p16INK4A와 HCⅡ검사의 결과를 비교하니, kappa계수는 0.034이였다. p16INK4A의 민감도는 30.8%, 특이 도는 82.4%였다(p<0.01). p16INK4A염색 결과 저등급 병변 이상이 나온 도말 검사의 표본과 조직 검사에서는 유용한 표지자이나, ASCUS시 병변을 예측하는 데는 유용하지 않았다. 결론 : ThinPrepTM 도말 검사의 ASCUS 병변에서 p16INK4A면역염색검사는 이상 병변의 발견을 위한 추적 검사로 유용하지 않은 것으로 사료된다.
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
강윤경,진소영,장미수,김정연,강경훈,이혜승,손진희,박호성,권계원,구미진,맹영희,주종은,강행지,김희경,장기택,이미자,장희경,김준미,한혜승,이원애,최윤정,강동욱,박선후,이재혁,조미연 대한병리학회 2013 Journal of Pathology and Translational Medicine Vol.47 No.3
Background: The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis. Methods: We collected datasheets from 25 insti-tutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathol-ogists. Results: The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The inci-dence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma. Conclusions: Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.