形形病变的发生频率:频率,观察者之间的变异性和免疫组织化学的附加值
Valentina Angerilli1,2, M Elisa Vink-Börger1, Nanette S van Roermund3,4,5
1Department of Pathology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
Histopathology
|March 14, 2026
概括
带有发育不良 (SSLd) 的形形病变是结肠直肠癌的前体. 这项研究发现MLH1免疫组织化学 (IHC) 是识别SSLd的有用生物标志物,在选定的情况下改善了诊断率.
科学领域:
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
- 在瘤学瘤学.
背景情况:
- 带有发育不良 (SSLd) 的形形病变难以诊断,是结直肠癌 (CRC) 的直接前体.
- 改善SSL中的发育不良的检测对于早期癌症预防至关重要.
研究的目的:
- 探索目前诊断SSLd的实践,并提供改善检测的建议.
- 评估SSL的发育不良的频率,并评估诊断差异.
主要方法:
- 在荷兰 (2014-2022年) 全国SSL频率和发育不良患病率研究.
- 对SSLd.的诊断实践和观察者间变异性的国家审计.
- 回顾性和前性队列研究评估生物标志物的实用性 (MLH1,p16,p53,β-catenin,c-myc) 用于SSLd检测.
- BRAF免疫组织化学 (IHC) 调查SSLd常规腺瘤的错误诊断.
主要成果:
- 在状状病变 (SSLs) 中,发育不良的频率为9.4% (在186,427个SSL中,有17456个).
- 在SSLd的诊断差异发生在11%的病例中,只有20%的实验室使用辅助IHC.
- MLH1 IHC是唯一一个显著增加SSLd诊断的生物标志物,无论是回顾性还是前性队列.
- 在先进的常规腺瘤中,SSLd的错误诊断是罕见的 (在1572例中有2例).
结论:
- 诊断SSLd显示出在病理学家中具有积极诊断趋势的良好可重现性.
- MLH1 IHC 是一种临床上有用的生物标志物,用于识别缺乏明显发育不良的SSLD,但由于患病率低,其使用应选择性.
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