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The utility of immunohistochemistry in the differential diagnosis of gynecologic disorders.

免疫组织化学在妇科疾病鉴别诊断中的应用

Abstract

Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and underdiagnosed neoplasms, and neoplasms with specific genetic alterations associated with overexpression or loss of expression of specific proteins. The diagnostic accuracy has been significantly improved owing to the discovery and increasing experience with the tumor-associated biomarkers, and the increasing demand for precise tumor classification to assess suitability for the expanding therapeutic modalities including clinical trials.
To differentiate lesions of the gynecologic tract through the use of effective immunohistochemical panels.
Literature review and authors' personal practice experience.
The application of diagnostic and prognostic immunohistochemical panels has enabled pathologists to better guide therapeutic decisions and to better predict the clinical outcome. It is now well established that the use of ancillary testing, including immunohistochemistry, has a significant power in the identification, differentiation, and classification of reactive, premalignant, and malignant gynecologic disorders. This article discusses the utilities and pitfalls of the commonly used immunohistochemical markers in the context of overlapping morphologic features encountered in the uterus, ovaries, and fallopian tubes.

摘要

免疫组织化学在一些妇科疾病的识别和界定中发挥越来越重要的作用,如富有欺骗性的、温和的形态学,少见的、诊断不出来的肿瘤,与特定蛋白过表达或不表达相关特定基因改变有关的肿瘤。随着肿瘤相关标记物的发现和经验的增加,诊断的准确率明显升高,并且提高了精准进行肿瘤分类的需求来评价包括临床实验在内多种治疗方式的适用性。

目的:有效地应用免疫组化套餐进行妇科疾病的鉴别诊断。

材料与方法:文献回顾和作者个人工作经验。

结论:诊断性和预后性免疫组化套餐的应用可以使病理医生更好地指导治疗和估计预后。使用辅助检查,如免疫组化能够对于反应性、癌前病变和恶性妇科病变很好地诊断、鉴别诊断和分类。本文对有形态学重叠的子宫、卵巢、输卵管病变,从常用的免疫组化标记物的应用、陷阱等方面加以讨论。

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