Document Detail

Immunohistochemical detection of XIAP and p63 in adenomatous hyperplasia, atypical adenomatous hyperplasia, bronchioloalveolar carcinoma and well-differentiated adenocarcinoma.
MedLine Citation:
PMID:  18432259     Owner:  NLM     Status:  MEDLINE    
The critical distinction of bronchioloalveolar carcinoma (BAC), well-differentiated adenocarcinoma (WDAC) of lung, adenomatous hyperplasia (AH) and atypical adenomatous hyperplasia (AAH), is based on morphological criteria alone, and is therefore potentially subjective. We examined expression of two markers, X-linked inhibitor of apoptosis protein (XIAP), the most potent of the inhibitor of apoptosis protein (IAP) family, and p63, a marker of bronchial reserve cells (BRC) and squamous cells, in these entities. H&E slides of 37 tissue blocks from 27 patients were reviewed and classified as AH (n=7), AAH (n=8), BAC (n=9) and WDAC (n=13). Immunostaining was performed on 4 mum sections with monoclonal anti-XIAP and monoclonal anti-p63. Granular or heterogeneous cytoplasmic staining for XIAP and nuclear staining for p63 were considered positive. Neither XIAP nor p63 were detected in normal lung alveolar cells. All seven AHs were negative for XIAP and negative or focally positive for p63. All eight AAHs were positive for XIAP and displayed p63 positivity in scattered cells. All BACs displayed XIAP positivity, which ranged from focal/weak to diffuse/strong. p63 was negative in seven and focally positive in two of nine BACs. Twelve of 13 WDACs showed XIAP positivity in a similar pattern to BAC; all were negative for p63. One aberrant case diagnosed on H & E as WDAC was negative for XIAP but strongly positive for p63. Significant XIAP expression appears to be useful for distinguishing AAH from AH. Commonality of XIAP staining in AAH, BAC and WDAC supports the possibility that AAH may be a pre-malignant lesion. The rarity of p63 expression confirms previous reports and supports a nonbronchial histogenesis of these entities. In contrast, diffuse p63 staining may facilitate the identification of rare cases that may have been misclassified as alveolar in origin based on morphology but may be of BRC origin.
Maoxin Wu; Lurmag Orta; Joan Gil; Gan Li; Alice Hu; David E Burstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-01
Journal Detail:
Title:  Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc     Volume:  21     ISSN:  0893-3952     ISO Abbreviation:  Mod. Pathol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-24     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806605     Medline TA:  Mod Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-8     Citation Subset:  IM    
1Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
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MeSH Terms
Adenocarcinoma / diagnosis*,  metabolism
Adenocarcinoma, Bronchiolo-Alveolar / diagnosis*,  metabolism
Diagnosis, Differential
Hyperplasia / pathology
Lung / pathology
Lung Neoplasms / diagnosis*,  metabolism
Membrane Proteins / biosynthesis*
Precancerous Conditions / diagnosis*,  metabolism
Tumor Markers, Biological / analysis
X-Linked Inhibitor of Apoptosis Protein / biosynthesis*
Reg. No./Substance:
0/CKAP4 protein, human; 0/Membrane Proteins; 0/Tumor Markers, Biological; 0/X-Linked Inhibitor of Apoptosis Protein; 0/XIAP protein, human

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