The oncofetal protein imp3 A 2 novel biomarker and triage tool for premalignant atypical endometriotic lesions

Capsule:
Immunohistochemical staining for IMP3 is a simple, inexpensive, and sensitive test that can be used as a triage tool to discriminate between preneoplastic atypia and confounding benign conditions.

Authors:
Paolo Vercellini, M.D., Fulvia Milena Cribiù, M.D., Alessandro Del Gobbo, M.D., Maria Luisa Carcangiu, M.D., Edgardo Somigliana, M.D., Ph.D., Silvano Bòsari, M.D.

Volume 99, Issue 7, Pages 1974-1979, June 2013

Abstract:

Objective:
To determine whether the oncofetal protein IMP3 is detectable in endometriomas with or without histological atypia and whether IMP3 staining can be used as a triage tool to identify foci of atypical endometriosis in doubtful cases.

Design:
Retrospective study.

Setting:
Academic department and referral center for endometriosis.

Patient(s):
A consecutive series of 516 women who underwent excision of 874 endometriomas.

Intervention(s):
Histological review by three expert pathologists and immunohistochemical staining for IMP3.

Main Outcome Measure(s):
Test performance of IMP3 immunohistochemistry versus first-round histology.

Result(s):
The prevalence of atypical endometriosis was 1.7% (95% confidence interval [CI], 0.9%–3.3%) based on the number of women and 1.0% (95% CI, 0.5%–1.9%) based on the number of cysts. Three cases of atypical endometriosis were identified at first-round histological examination. Immunohistochemistry detected seven of the eight cases diagnosed as preneoplastic atypia at second-round histology and one case diagnosed as reactive atypia at second-round histology. The sensitivity of first-round histology was 33.3%, compared with 88.9% of IMP3 immunohistochemistry.

Conclusion(s):
Immunohistochemical staining for IMP3 expression is a simple, inexpensive, and sensitive test that can be used in routine clinical practice as a triage tool to discriminate between cytological/structural atypia and confounding benign conditions.

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