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目的探讨胸腺瘤各亚型中P63的表达及其在病理诊断中的意义。方法收集76例胸腺上皮肿瘤(TET;包括胸腺瘤及胸腺癌)标本,应用免疫组化技术(SP法)检测P63在TET各亚型中的表达。同时对比分析初始诊断、复核诊断及参考P63表达诊断3组结果。结果复核诊断发现9例误诊,主要集中在胸腺瘤AB型和B型,还有3例不能确诊。P63不同程度阳性表达于72例TET中,定位于肿瘤细胞核,并在不同TET亚型中呈现不同形态和分布特点。参考P63表达结果的病理诊断的准确率优于未参考P63的初始病理诊断的准确率(TET:P=0.017;胸腺瘤:P=0.032)。结合P63的表达帮助确诊了复诊中不能明确的3例胸腺瘤亚型。结论鉴于结合P63表达能更好地区分胸腺瘤各亚型,我们建议在临床病理诊断中将其作为常规标记物,尤其在诊断胸腺瘤AB型和B型时。
Objective To investigate the expression of P63 in various subtypes of thymoma and its significance in pathological diagnosis. Methods Sixty-six specimens of thymic epithelial tumor (TET; including thymoma and thymic carcinoma) were collected. The expression of P63 in TET subtypes was detected by immunohistochemistry (SP method). At the same time, comparative analysis of the initial diagnosis, review diagnosis and reference P63 expression diagnosis of three groups of results. Results The diagnosis of misdiagnosis was found in 9 cases, mainly in type AB and type B of thymoma, and 3 cases could not be diagnosed. The positive expression of P63 in different degrees of TET was localized in the nucleus of tumor cells and showed different morphological and distributional features in different TET subtypes. The accuracy of the pathological diagnosis with reference to the results of P63 expression was superior to the accuracy of the initial pathological diagnosis with no reference to P63 (TET: P = 0.017; Thymoma: P = 0.032). Combined with the expression of P63 to help confirm the referral can not be clearly defined in 3 cases of thymoma subtype. Conclusions In view of the better discrimination between the subtypes of thymoma in combination with P63 expression, we suggest that it be used as a routine marker in clinicopathological diagnosis, especially in the diagnosis of thymic adenoma types AB and B.