scholarly journals Greater specificity of p40 compared with p63 in distinguishing squamous cell carcinoma from adenocarcinoma in effusion cellblocks

CytoJournal ◽  
2020 ◽  
Vol 17 ◽  
pp. 13
Author(s):  
Nah Ihm Kim ◽  
Ji Shin Lee

Objective: Squamous cell carcinoma (SCC) rarely causes malignant effusions. Distinguishing between SCC and adenocarcinoma in effusion cytology can be a challenge. p63 and p40 have been frequently used to support squamous cell differentiation in both histological and cytological specimens. However, similar results in cytological preparations of effusion fluids have been rarely reported. This study was designed to assess the diagnostic value of p63 and p40 immunoreactivity for the differentiation of SCC from adenocarcinoma in malignant effusions. Materials and Methods: Immunocytochemical staining of p63 and p40 was performed on thirty cellblock specimens, including ten malignant effusions carrying SCC and twenty malignant effusions showing adenocarcinoma. Any degree of nuclear staining was considered positive. Results: Of the ten SCC cases, 100% tested positive for both p63 and p40, and most cases showed diffuse staining (>25% of tumor cells). The expression of p63 and p40 was detected in 4 (20%) and 2 (10%) of twenty adenocarcinoma cases, and the extent of staining was all focal (≤25% of tumor cells). The p63 reactivity showed 100% sensitivity, 80% specificity, 71% positive predictive value, and 100% negative predictive value for the differentiation of SCC from adenocarcinoma in malignant effusions. The sensitivity of p40 for SCC was 100%, the specificity was 90%, the positive predictive value was 83%, and the negative predictive value was 100%. Conclusion: Although p63 and p40 are both useful markers for the diagnosis of SCC in malignant effusions, p40 is more specific than p63 in distinguishing SCC from adenocarcinoma.

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Edson Ide ◽  
Fred Olavo Aragão Andrade Carneiro ◽  
Mariana Souza Varella Frazão ◽  
Dalton Marques Chaves ◽  
Rubens Antônio Aissar Sallum ◽  
...  

Chromoendoscopy with Lugol's staining remains the gold standard technique for detecting superficial SCC. An alternative technique, such as narrow-band imaging (NBI), for “optical staining” would be desirable, since NBI is a simpler technique and has no known complications. In this study, we compare NBI without magnification and chromoendoscopy with Lugol's staining for detecting high-grade dysplasia and intramucosal esophageal squamous cell carcinoma (SCC) in patients with achalasia. This was a prospective observational study of 43 patients with achalasia referred to the Gastrointestinal Endoscopy Unit of the Hospital of Clinics, São Paulo, University Medical School, Brazil, from October 2006 to February 2007. Conventional examinations with white light, NBI, and Lugol staining were consecutively performed, and the suspected lesions were mapped, recorded, and sent for biopsy. The results of the three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value, and negative likelihood value. Of the 43 patients, one was diagnosed with esophageal squamous cell carcinoma, and it was detected by all of the methods. NBI technology without magnification has high sensitivity and negative predictive value for detecting superficial esophageal squamous cell carcinoma, and it has comparable results with those obtained with Lugol's staining.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P39-P40 ◽  
Author(s):  
Kimberly J. Lee ◽  
Claudia Kirsch ◽  
James William Sayre ◽  
Sunita Bhuta ◽  
Elliot Abemayor

Objective Detection of early regional metastasis of head and neck carcinoma is critical for tumor staging, prognosis, and treatment strategies. Clustered cervical lymphadenopathy portends a worse prognosis than isolated lymphadenopathy, but studies analyzing its effect are lacking. Key objectives include: 1) to establish criteria for lymph node clustering and 2) to assess the predictive value of lymph node clustering for metastasis. Methods This study retrospectively reviewed preoperative radiographic images of 29 patients with histopathologically proven metastatic head and neck squamous cell carcinoma between January 2006 and December 2007. Patients who had previous radiation or chemotherapy were excluded. CT, MRI, and PET CT images were assessed for lymph node size and number, neck level, and clustering, with respect to primary tumor location and size. A cluster was defined as 3 or more abutting nodes with no definable intervening fat planes. Results Statistics comparing histopathologic proven metastatic lymphadenopathy and radiographic clustering of nodes in each neck level were used to elucidate the positive predictive value via logistic regression analysis. Analysis revealed a positive predictive value for clustering of nodes greater than 1 cm to be 82.9%, with a negative predictive value of 100% in the level II region (p<0.05). Nodes in the remaining levels demonstrated less predictive values. Conclusions Clustered lymph nodes greater than 1cm in the level II region in head and neck squamous cell carcinoma have a high predictive value, suggesting that clustering is not only an important prognostic indicator but also an important radiographic feature that may assist surgeons in preoperative surgical planning.


2012 ◽  
Vol 42 (1) ◽  
Author(s):  
Bambang Hariwiyanto ◽  
Camelia Herdini ◽  
Inawati Bobot

Background: Squamous cell carcinoma (SCC) is the most frequent malignancy in the head and neck. The treatment modalities of SCC are surgery followed by chemotherapy and/or radiotherapy, could also chemotherapy and/or radiotherapy without surgery. The gold standard of assessing success  in SCC treatment is if there no malignant cells found not only in frozen section tissues, but also in  post chemotherapy and/or radiotherapy tissues. Determining the spot of biopsy tissue for malignancy assessment after treatment is not easy. Toluidin Blue (TB) is a staining material, absorbed by intercellular space in epithelial dysplasia, included SCC.   To determine the validity of Toluidin Blue as sign of accuracy for biopsy site in SCC post treatment malignancy, which not only for surgically treated cases, but also after chemotherapy and/or radiotherapy without surgical treatment. Method: Diagnostic test study to determine sensitivity test, specificity test, positive predictive value and negative predictive value of TB to detect malignant cells in post treatment head and neck SCC patients. Result: There were 30 samples biopsy material from 30 post treatment SCC patients. Sensitivity test was 83,3%, specificity  test: 66,7%, positive predictive value: 79.0%, negative predictive value: 72,7%. Conclusion: TB staining is accurate for determining biopsy spot in post treatment head and neck SCC. Keyword : Validity, toluidin blue, squamous cell carcinoma, post treatment.  Abstrak :  Latar belakang: Karsinoma sel skuamosa (KSS) merupakan jenis keganasan kepala dan leher yang paling sering dijumpai dibanding keganasan yang lain. KSS kepala leher dapat dilakukan terapi pembedahan diikuti kemoterapi dan/atau radioterapi maupun kemoterapi dan/atau radioterapi tanpa pembedahan. Penentuan keberhasilan radikalitas pengobatan ditandai dengan tidak adanya sisa tumor secara mikroskopis yang diambil pada jaringan pasca kemoradiasi tanpa pembedahan, atau pemeriksaan jaringan secara frozen section. Untuk menentukan apakah pada jaringan masih ada sisa tumor atau sudah bebas tumor secara makroskopis terkadang sulit. Toluidin Blue (TB) adalah zat pewarna yang dapat terserap pada ruang interseluler epitel yang mengalami displasia seperti yang terjadi pada KSS. Tujuan: Menilai validitas pewarnaan TB sebagai petanda ketepatan lokasi biopsi KSS pasca terapi, baik pasca pembedahan, maupun yang diterapi dengan kemoterapi dan/atau radioterapi tanpa pembedahan. Metode: Uji diagnostik untuk menentukan sensitifitas dan spesifitas pewarnaan, nilai duga positif dan nilai duga negatif TB sebagai salah satu petanda ketepatan biopsi KSS pasca terapi KSS kepala-leher. Hasil: Didapatkan 30 sampel penelitian yang berasal dari 26 penderita KSS yang telah dilakukan terapi baik bedah maupun kemoradiasi tanpa bedah. Sensitifitas pewarnaan TB terhadap hasil biopsi pasca terapi 83,3%, spesifitas 66,7%, nilai duga positif 79,0% dan nilai duga negatif 72,7%. Kesimpulan: Pewarnaan TB valid untuk menentukan ketepatan biopsi keganasan KSS kepala dan leher pasca terapi. Kata kunci: Validitas, toluidin blue, karsinoma sel skuamosa, pasca terapi


2018 ◽  
Vol 39 (10) ◽  
pp. 1884-1888 ◽  
Author(s):  
P. Wangaryattawanich ◽  
B.F. Branstetter ◽  
M. Hughes ◽  
D.A. Clump ◽  
D.E. Heron ◽  
...  

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989386
Author(s):  
Rui Guo ◽  
Yi Tian ◽  
Na Zhang ◽  
Hong Huang ◽  
Ying Huang ◽  
...  

Objective To assess the value of dual-marker immunostaining for detecting p40 and napsin A, and cytokeratin 5/6 (CK5/6) and thyroid transcription factor 1 (TTF1) in single sections of lung cancer tissue, for differentiating between lung squamous cell carcinoma and adenocarcinoma. Methods Lung cancer tissue sections from 58 patients were stained by dual-marker immunostaining using a mixtures of anti-p40 and anti-napsin A, and anti-CK5/6 and anti-TTF1 primary antibodies. Sections stained with single markers were used as controls. Nuclear or cytoplasmic staining was considered as indicating positive p40 or napsin A expression, respectively, and cytoplasmic or nuclear staining was considered as indicating positive CK5/6 or TTF1 expression, respectively. Results p40/napsin A and CK5/6/TTF1 dual-marker staining showed high sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of squamous cell carcinoma and adenocarcinoma respectively. There were no differences in marker expression between dual-marker and single-marker staining. Conclusions Dual-marker immunostaining is a relatively easy, time- and cost-conserving staining method for detecting two markers in a single section using one procedure and one chromogen. p40 and napsin A, and CK5/6 and TTF1 dual-marker staining were suitable for the differential diagnosis of lung squamous cell carcinoma and adenocarcinoma.


2018 ◽  
Vol 8 (2) ◽  
pp. 18-22
Author(s):  
Md Ariful Islam ◽  
Md Nasir Uddin ◽  
Md Shahjahan Ali ◽  
Md Mahfuz Hossain

Background: Oral squamous cell carcinoma which occurs closely to the mandible has a tendency to invade mandible. An accurate preoperative evaluation of mandibular invasion is important for optimum treatment planning. Aim of this study is to determine the accuracy of CBCT in detection of mandibular invasion in oral squamous cell carcinoma. Study design: In this prospective observational study 35 patients of histologically proven squamous cell carcinoma which was close proximity to the mandible were selected. The results of preoperative CBCT scan of mandible were compared with that of post operative histopathology of bone and thus sensitivity, specificity, negative predictive value, positive predictive value were calculated. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CBCT were 96%, 90.90%, 96%, 90.90%, 97.14% respectively (Chi squared with Yates correction equals 21.844 with 1 degrees of freedom, p value < o.oooo1). Conclusion: Cone beam computed tomography is a sensitive test and has an acceptable range of specificity. Update Dent. Coll. j: 2018; 8 (2): 18-22


Author(s):  
Gloria Dapaah ◽  
Jos Hille ◽  
William C. Faquin ◽  
Judith Whittaker ◽  
Corneli M. Dittrich ◽  
...  

Context.— Limited data exist on the prevalence of human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma in sub-Saharan Africa. Objective.— To determine the prevalence of HPV-positive oropharyngeal squamous cell carcinoma at a large tertiary care center in South Africa. Design.— A total of 266 oropharyngeal squamous cell carcinomas diagnosed during an 11-year period (2007–2017) were selected for evaluation. Cases staining positive for p16 immunohistochemistry were evaluated for high-risk HPV using the BD Onclarity assay (BD Diagnostics, Sparks, Maryland). Results.— Of 266 oropharyngeal squamous cell carcinomas, 14% (n = 36) were positive for p16. Polymerase chain reaction for high-risk HPV performed on the p16-positive cases was negative in 23 cases and positive in 13 cases (13 of 266; 5%). p16 showed a positive predictive value of 36.1%. The HPV subtypes were HPV-16 (n = 10), HPV-18 (n = 1), HPV-52 (n = 1), and HPV-31 (n = 1). Human papillomavirus–positive cases occurred in 10 men and 3 women (mean age, 51 years) and arose from the tonsil (n = 10) or base of the tongue (n = 3). The HPV-positive cases were non-keratinizing (n = 10) or partially keratinizing (n = 1). Partially/nonkeratinizing cases revealed a modest improvement in p16 positive predictive value (11 of 21; 52.4%). Conclusions.— The presence of high-risk HPV in 5% of cases suggests that high-risk HPV is a minor etiologic agent in oropharyngeal squamous cell carcinoma in this region. Given its suboptimal positive predictive value, p16 is not a reliable marker for high-risk HPV infection in this region. When p16 is positive, HPV-specific testing is necessary. The identification of less common high-risk HPV types, HPV-52 and HPV-31, may influence current local vaccination strategies.


2021 ◽  
Vol 8 (2) ◽  
pp. 246
Author(s):  
Dhanya R. Thankam ◽  
Aria Jyothi A.

Background: Oral squamous cell carcinoma is the 6th most common malignancy in the world and ranks as first in males in Indian sub-continent. Vimentin is an intermediate filament found in mesenchymal cells and e-cadherin is an adhesion molecule found in epithelial cells. The objective of the study is to evaluate the expression of e-cadherin and vimentin in lesions of oropharynx and to assess the sensitivity, specificity and positive predictive value of e - cadherin and vimentin in oropharyngeal squamous cell carcinoma (OPSCC), against routine H and E stained histopathological diagnosis.Methods: 100 oropharyngeal biopsy specimens taken and routine H and E stained histopathological slide diagnosis made. E-cadherin and vimentin expression studied in OPSCC, moderate to severe dysplasia, mild dysplasia and benign cases and its sensitivity, specificity, positive predictive value and negative predictive value analysed using appropriate statistical tools.Results: Vimentin positivity was observed in 70 out of 79 OPSCC, 2 out of 3 cases of moderate - severe dysplasia, 0 out of 2 mild dysplasia and 2 out of 16 benign lesions. Out of 79 cases of OPSCC, 15 were e-cadherin negative, 27 showed low and 37 cases showed high membraneous positivity.Conclusions: We observed a significant decrease in e-cadherin membrane expression from dysplasia to carcinoma insitu to invasive carcinoma and a significant increase in vimentin expression with progression of the tumor. E-cadherin is a good prognostic marker whereas vimentin expression indicates a poor prognosis.


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