Defining an abnormal p53 immunohistochemical stain in Barrett's oesophagus-related dysplasia: a single-positive crypt is a sensitive and specific marker of dysplasia.

Autor: Tomaszewski KJ; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Neyaz A; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Sauder K; Department of Pathology, Newton-Wellesley Hospital, Newton, MA, USA., Rickelt S; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA., Zhang ML; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Yilmaz O; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Crotty R; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Shroff S; Department of Pathology, Massachusetts General Hospital, Boston, MA, USA., Odze R; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA., Mattia A; Department of Pathology, Newton-Wellesley Hospital, Newton, MA, USA., Patil DT; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA., Deshpande V; Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Histopathology [Histopathology] 2023 Mar; Vol. 82 (4), pp. 555-566. Date of Electronic Publication: 2023 Jan 16.
DOI: 10.1111/his.14848
Abstrakt: Aims: p53 is an independent risk stratification marker in Barrett's oesophagus (BE), but no universally accepted definition exists for abnormal p53 staining. Herein, we assess p53 stains in two cohorts to: (1) define abnormal p53 staining in BE-related dysplasia (BERD) and (2) assess the specificity and sensitivity of this cut-point for the diagnosis of dysplasia.
Methods: Cohort 1 (n = 313) included (1) dysplastic BE biopsies, (2) prior non-dysplastic BE (NDBE) biopsies from the same patients and (3) NDBE biopsies from patients who never progressed to dysplasia. Cohort 2 (n = 191) consisted of BE biopsies in which p53 staining aided in diagnosing dysplasia. Automated p53 staining quantification was performed on cohort 1. A semiquantitative p53 analysis, performed on both cohorts, included: (1) number of strongly positive glands, (2) strong glandular surface staining, (3) percentage of strongly positive glands and (4) null phenotype.
Results: NDBE biopsies from cohort 1 patients who progressed to dysplasia were more likely to show p53 positivity than non-progressors (16.9 versus 0.6%) (P = 0.0001). The optimal quantitative cut-point for distinguishing dysplastic from never-dysplasia biopsies was 10 strongly positive cells. By semiquantitative analysis, a single strongly p53-positive gland distinguished dysplastic from never-dysplasia BE (sensitivity 98.6%, specificity 99.4%). The semiquantitative and quantitative analyses correlated (P = 0.0001). In cohort 2, the sensitivity and specificity for BERD of ≥ 1 strongly positive p53 gland were 86.0 and 88.6%.
Conclusions: A single strongly positive p53 gland is sensitive and specific for BERD. Automated p53 analysis may reduce subjectivity associated with the diagnosis of BERD.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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