Biomarkers in diagnostic obstetric and gynecologic pathology: a review.
Until recently, the histologic diagnosis of obstetrical and gynecologic neoplasia was based principally on morphologic criteria. However, interobserver reproducibility for entities such as squamous intraepithelial, endometrial, and trophoblastic disease varies widely between observers. This inherent variability in interpretation between individuals has led to wide ranges in diagnostic precision between practices, and in many cases, between recognized experts. The advent of immunohistochemistry, and the more recent accelerated discovery of new genes and their functions has resulted in the discovery of cellular proteins or nucleic acids that are differentially expressed in tumors. When applied in conjunction with existing histologic criteria, these "biomarkers" have the potential to enhance diagnostic consistency and reproducibility. The gains expected are to practicing diagnostic pathologists (who will enjoy greater diagnostic consistency) and to academics (for whom biomarkers may uncover new pathways unappreciated by histologic diagnosis alone). However, fundamental to the success in both arenas will be critical analysis of the potential pitfalls in immunohistochemistry, strict validation of new markers as they arrive in the field, and a realistic view of their value in the laboratory management of obstetrical and gynecologic diseases.
Nucci
Marisa R
MR
Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachussetts 02115, USA.
Castrillon
Diego H
DH
Bai
Hongwei
H
Quade
Bradley J
BJ
Ince
Tan A
TA
Genest
David R
DR
Lee
Kenneth R
KR
Mutter
George L
GL
Crum
Christopher P
CP
D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D005833:Genital Neoplasms, Female / Q000737:chemistry* / Q000473:pathology*; D025743:HMGA2 Protein / Q000032:analysis; D006801:Humans; D006828:Hydatidiform Mole / Q000737:chemistry / Q000473:pathology; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D051059:PTEN Phosphohydrolase; D010744:Phosphoric Monoester Hydrolases / Q000032:analysis; D011247:Pregnancy; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D025521:Tumor Suppressor Proteins / Q000032:analysis; D014412:Tumor Virus Infections / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology; D014594:Uterine Neoplasms / Q000737:chemistry / Q000473:pathology; D014846:Vulvar Neoplasms / Q000737:chemistry / Q000473:pathology / Q000821:virology
D014408:Biomarkers, Tumor; D025743:HMGA2 Protein; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D025521:Tumor Suppressor Proteins; D010744:Phosphoric Monoester Hydrolases; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human