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Interpretation of P53 Immunohistochemistry in Endometrial Carcinomas: Toward Increased Reproducibility
Martin Köbel1, Brigitte M Ronnett, Naveena Singh
1Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta (M.K.) Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia (C.B.G.), Canada Department of Pathology and Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland (B.M.R.) Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (R.A.S.) Department of Cellular Pathology, Barts Health NHS Trust, London (N.S.) Department of Pathology, Belfast Health and Social Care Trust, Belfast (W.G.M.), UK.
Abstract:
P53 immunohistochemistry has evolved into an accurate surrogate reflecting the underlying TP53 mutation status of a tumor, and has utility in the diagnostic workup of endometrial carcinomas. Recent work predominantly carried out in tubo-ovarian high-grade serous carcinoma has revealed 4 main patterns of p53 staining (normal/wild-type, complete absence, overexpression, and cytoplasmic); the latter 3 patterns are variably termed abnormal/aberrant/mutation-type and are strongly predictive of an underlying TP53 mutation. The aim of this review is to provide practical advice to pathologists regarding various aspects of p53 immunohistochemical staining. These include laboratory methods to optimize staining, a description of the different patterns of staining, advice regarding the interpretation, and reporting of p53 staining and practical uses of p53 staining in endometrial carcinoma diagnosis. Illustrations are provided to aid in the interpretational problems.
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