CLINICAL FEATURES AND IMMUNOEXPRESSION OF p53, MIB-1 AND PROLIFERATING CELL NUCLEAR ANTIGEN IN ADRENAL NEOPLASMS

Martins, Antônio Carlos Pereira; Cologna, Adauto José; Tucci, Sílvio; Suaid, Haylton Jorge; Falconi, Rodrigo Alexandre Rossi

doi:10.1097/01.ju.0000157683.55748.41

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…There is a high probability that histopathological features of a tumour are better predictors of its malignant potential than immunohistochemical characteristics. It seems that a mitotic index together with classical histopathological criteria are the most essential factors in the differentiation between malignant and benign adrenocortical masses [15,17,20,21,29,31] . Alongside this, some authors advise the complementation of histopathology with an immunochemical examination of p53 and Ki67 expression therefore helping to identify malignancy of a detected lesion [14] .…”

Section: Discussionmentioning

confidence: 99%

The Role of Immunohistochemistry in Histopathological Diagnostics of Clinically “Silent” Incidentally Detected Adrenal Masses

Babińska

Sworczak²,

Wiśniewski³

et al. 2008

Exp Clin Endocrinol Diabetes

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We found a statistically significant correlation between the expression of p53, p21, Ki67 and the differential diagnosis of adrenal cortical adenoma and adrenocortical carcinoma (for proteins: p53 p=0.010, for p21 p=0.010, for Ki67 p<0.001). The statistical significant correlation between PCNA protein and diagnosis of adrenal cortical adenoma and adrenocortical carcinoma was not found. The statistically significant correlation between p21, PCNA proteins and the diagnosis of benign and malignant PHEOs was not estimated. There was no expression of Ki67 or p53 protein above the assumed level in benign and malignant pheochromocytomas. The statistically significant correlation between p53, p21, PCNA or Ki67 and the occurrence of metastases in adrenocarcinoma and malignant PHEOs was not found.

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Section: Discussionmentioning

confidence: 99%

The Role of Immunohistochemistry in Histopathological Diagnostics of Clinically “Silent” Incidentally Detected Adrenal Masses

Babińska

Sworczak²,

Wiśniewski³

et al. 2008

Exp Clin Endocrinol Diabetes

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“…Apart from standard histopathology, the role of immunohistochemistry in the subclassification of adrenocortical neoplasms has been investigated in many studies. For example, expression of p53 protein, MIB1 antigen and proliferating cell nuclear antigen show differences in adenomas and carcinomas, but the sensitivity and specificity are insufficient to be used in clinical practice 14–20 …”

Section: Discussionmentioning

confidence: 99%

The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas

et al. 2007

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“…Therefore, molecular and cellular features of human adrenocortical carcinoma are clinically of no value and/or significance in differentiation between adrenocortical adenomas and carcinomas even if meticulously and elegantly performed unless the findings are correlated with morphological features. Among these molecular and/or cytological markers that may contribute to the differential diagnosis of adrenocortical carcinoma at least at this juncture, the cell proliferation markers such as Ki-67 and topoisomerase can be of most value [15][16][17][18][19][20]. Results of recent studies using Ki-67 or MIB1 index for differential diagnosis between adrenocortical adenoma and carcinoma are summarized in Table 1.…”

Section: Immunohistochemical Diagnosismentioning

confidence: 99%

Recent advances in histopathology and immunohistochemistry of adrenocortical carcinoma

2006

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Discerning malignancy in resected adrenocortical neoplasms can pose diagnostic difficulty. Macroscopic examination is the first important step toward diagnosis and should include accurate measurement of weight and dimension of the specimens and description of the cut surface of the tumors. It is also important to sample the specimens for histological diagnosis near foci of hemorrhage and/or necrosis. Histological scoring systems evaluating multiple parameters, especially the criteria of Weiss, have been shown to be reliable in differential diagnosis between adrenocortical adenoma and carcinoma. A tumor is defined as adrenocortical carcinoma when three or more of the following criteria are met; (1) high nuclear grade, (2) mitotic rate six or more per 50 high power fields, (3) atypical mitosis, (4) clear cells less than 25%, (5) a diffuse architecture pattern in more than one-third of the tumor, (6) confluent necrosis, (7) venous invasion, (8) sinusoidal invasion, and (9) capsular invasion. The criteria are relatively straightforward and considered the most effective standard for diagnosis of adrenocortical malignancy. However, great care should be taken in applying the criteria to histological evaluation of two relatively rare and peculiar adrenocortical tumors, adrenocortical oncocytoma and pediatric adrenocortical neoplasms. At this juncture, ancillary biological or molecular markers are of little practical value in terms of differential diagnosis between adrenocortical adenoma and carcinoma but tumors with MIB1 or Ki-67 labeling index more than 2.5 may be considered malignant. Prognostic markers of adrenocortical carcinoma have not been established other than complete respectability of the tumor. There are also no surrogate markers for predicting response to therapy with Mitotane, an adrenolytic agent. It sometimes is important for surgical pathologists to differentiate adrenocortical carcinoma from metastatic malignancies of other sites. An immunohistochemical evaluation of adrenal 4 binding protein (Ad4BP) or SF-1, a transcription factor of all steroidogenesis, can aid in this differential diagnosis because nuclear immunoreactivity for this transcription factor is relatively specific to steroid producing cells.

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CLINICAL FEATURES AND IMMUNOEXPRESSION OF p53, MIB-1 AND PROLIFERATING CELL NUCLEAR ANTIGEN IN ADRENAL NEOPLASMS

Abstract: Endocrine syndromes differed in adults and children but other clinical features were similar in both groups. The role of p53 protein, MIB-1 antigen and proliferating cell nuclear antigen in discrimination of adenomas from carcinomas is unclear.

Cited by 9 publications

References 17 publications

The Role of Immunohistochemistry in Histopathological Diagnostics of Clinically “Silent” Incidentally Detected Adrenal Masses

The Role of Immunohistochemistry in Histopathological Diagnostics of Clinically “Silent” Incidentally Detected Adrenal Masses

The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas

Recent advances in histopathology and immunohistochemistry of adrenocortical carcinoma

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