Perioperative diagnosis of cystosarcoma phyllodes of the breast may be enhanced by MIB-1 index
| Autor: | L. Harbin, P.B. Rajan, Paul Ziprin, David H. Peck, Paul F. Ridgway, Rosamond Jacklin, Ara Darzi |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Biopsy Mammary gland Population Breast Neoplasms Sensitivity and Specificity Surgical planning Diagnosis Differential Phyllodes Tumor medicine Humans Child education Retrospective Studies education.field_of_study biology business.industry Perioperative Middle Aged medicine.disease Immunohistochemistry Fibroadenoma Surgery Ki-67 Antigen medicine.anatomical_structure Ki-67 Radiological weapon biology.protein Female business Mib 1 index |
| Zdroj: | Journal of Surgical Research. 122:83-88 |
| ISSN: | 0022-4804 |
| Popis: | The recurring theme in cystosarcoma phyllodes (CSP) is one of underdiagnosis by pathologists and undertreatment by surgeons. Major areas of investigation relating to the diagnosis of CSP center on accurate preoperative diagnosis, elucidating the relevance of histological classification with respect to outcome, and identifying novel markers to reliably differentiate CSP from fibroadenoma (FA).Fifteen CSP and 7 cellular FA controls (where the preoperative diagnosis was unclear) were retrospectively investigated. Preoperative histological and radiological investigations were reviewed for efficacy. The ability of MIB-1 antibody to differentiate the two fibroepithelial lesions was investigated using immunohistochemical estimation of the MIB-1 index.Preoperative core biopsy had a sensitivity of 75% but was carried out in only 23% of cases. Fine needle aspiration cytology and radiological assessment were not efficacious in preoperative diagnosis. Proliferative activity (MIB-1 indices) was significantly higher in CSP than in a selected population of FA where there was preoperative diagnostic uncertainty (P0.0001). Indices were also able to determine CSP subclassification. This suggests MIB-1 as a constructive adjunctive investigation when evaluating histological features to differentiate CSP from FA in difficult cases.The use of MIB-1 may increase the sensitivity of preoperative core biopsy diagnosis, offering more effective surgical planning and decreasing immediate reoperation rates. |
| Databáze: | OpenAIRE |
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