title: MIB-1 immunostaining is a beneficial adjunct test for accurate diagnosis of vulvar condyloma acuminatum.
abstract: The histopathologic diagnosis of vulvar condyloma acuminatum is often based on architectural features that are not specific for human papillomavirus (HPV) infection. Because HPV-associated lesions show increased cellular proliferation, the authors evaluated the usefulness of MIB-1 immunostaining as an aid in the differential diagnosis of cases equivocal for condyloma. The MIB-1 immunostaining pattern was correlated with HPV DNA detection in condyloma acuminatum (CON-A; n = 15), "consistent with condyloma" (c/w CON-A; n = 26), fibroepithelial polyp (FEP; n = 14), and squamous papilloma (n = 10). HPV was detected in 100% of the CON-A cases, and all cases demonstrated MIB-1-positive nuclei in the upper two thirds of the epithelial thickness. With this definition of MIB-1 positivity, there was complete concordance between MIB-1 positivity and HPV detection for all cases (kappa = 0.88). Of the cases c/w CON-A, 17 of 26 (65%) were positive for both MIB-1 and HPV, and could be reclassified as CON-A, whereas 35% were identified as an overdiagnosis based on negative results. In addition, two cases of FEP were MIB-1 and HPV positive, and thus were identified as an underdiagnosis. These results suggest significant overdiagnosis of cases equivocal for condyloma, and indicate that MIB-1 immunostaining is a beneficial adjunctive test when the morphologic features are suggestive but not diagnostic for CON-A.
authors.affiliation: Department of Pathology, New York Presbyterian Hospital-Weill Medical College of Cornell University, NY 10021, USA. ecpirog@mial.med.cornell.edu
authors.forename: E C
authors.initials: EC
authors.lastname: Pirog
authors.forename: Y T
authors.initials: YT
authors.lastname: Chen
authors.forename: C
authors.initials: C
authors.lastname: Isacson
mesh_terms: D034961:Antigens, Nuclear; D003218:Condylomata Acuminata / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D019394:Ki-67 Antigen; D009687:Nuclear Proteins / Q000378:metabolism*; D010212:Papilloma / Q000175:diagnosis / Q000378:metabolism / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D016133:Polymerase Chain Reaction; D011127:Polyps / Q000175:diagnosis / Q000378:metabolism / Q000821:virology; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000821:virology
chemical_list: D034961:Antigens, Nuclear; D004279:DNA, Viral; D019394:Ki-67 Antigen; D009687:Nuclear Proteins