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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Can p63 Alone Resolve the Mystery of Suspicious Lesions in Prostate Biopsies?-A Study of Interobserver Agreement
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Can p63 Alone Resolve the Mystery of Suspicious Lesions in Prostate Biopsies?-A Study of Interobserver Agreement

机译：p63能否单独解决前列腺穿刺活检中可疑病变的奥秘？-观察者协议研究

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Prostatic biopsies more often, present diagnostic dilemma raising the suspicion of malignancy. Small acinar pattern, limited atypical glands and benign mimickers are few pitfalls. Markers like p63, High Molecular Weight Cytokeratin (HMWCK) detect presence/absence of basal cells and p504s, malignant epithelial cells. This study highlights the usefulness of p63 alone in the resolution of suspicious foci.Aim: To ascertain the effectiveness of p63 in resolving doubtful prostatic biopsies.Materials and Methods: Cross-sectional study on 30 prostatic biopsies with suspicious foci from January 2014 to July 2016. Immunohistochemistry with p63, HMWCK and p504s was performed on all the biopsies and final diagnosis was arrived at. The routine paraffin sections and p63 slides were reviewed by two independent pathologists who were blinded to the above diagnosis. Their opinion was analysed against the final diagnosis with SPSS v.23 to calculate sensitivity, specificity and interobserver agreement.Results: The diagnosis achieved by performing three markers were benign in 24 and adenocarcinoma in six cases. Pathologist 1 concurred in 30 (100%) cases and pathologist 2 in 29 (97%). A p63 had (6/6) 100% sensitivity and specificity in diagnosing adenocarcinoma with pathologist 1. With pathologist 2, it had sensitivity of (6/6) 100% and specificity of (23/24) 95.83%. Cohen?s kappa was 0.902 which showed significant agreement.Conclusion: A p63 alone can help the pathologist to arrive at a diagnosis and is highly sensitive and specific. Interobserver agreement is also significant indicating high reproducibility.
机译：前列腺活检更常出现诊断难题，增加了对恶性肿瘤的怀疑。较小的腺泡状结构，非典型腺体稀少和良性模仿者很少有陷阱。诸如p63，高分子量细胞角蛋白（HMWCK）等标记可检测是否存在基底细胞和p504s（恶性上皮细胞）。这项研究强调了单独使用p63在解决可疑病灶中的作用。目的：确定p63在解决可疑的前列腺活检中的有效性。材料和方法：对30例有可疑病灶的前列腺活检进行横断面研究从2014年1月至2016年7月。对所有活检组织进行了p63，HMWCK和p504s的免疫组织化学检查，并最终诊断出来。两名独立的病理学家对常规石蜡切片和p63玻片进行了检查，他们对上述诊断不知情。他们的意见针对SPSS v.23的最终诊断进行了分析，以计算敏感性，特异性和观察者之间的一致性。结果：通过执行三种标志物实现的诊断为良性24例，腺癌6例。病理学家1同意30（100％），病理学家2同意29（97％）。 p63与病理学家1诊断腺癌的敏感性和特异性为（6/6）100％。对于病理学家2，p63的敏感性为（6/6）100％，特异性为（23/24）95.83％。科恩氏kappa为0.902，这表明有显着一致性。观察者之间的协议也很重要，表明可重复性很高。

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