免疫组化在胸膜上皮性恶性肿瘤鉴别诊断中的价值  

Value of immunohistochemistry in distinguishing malignant epithelial tumors in the pleura

作　　者：张艳梅[1] 付红[1] 张颖[1] 

机构地区：[1]哈尔滨医科大学附属第二医院病理科,150086

出　　处：《中国肺癌杂志》2007年第4期320-323,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的胸膜上皮性恶性肿瘤鉴别诊断难度较大,本文旨在探讨免疫组化在胸膜恶性间皮瘤与转移性肺腺癌鉴别诊断中的作用。方法用免疫组化S-P法检测56例胸膜上皮性恶性肿瘤中波形蛋白、间皮细胞(MC)、钙结合蛋白(CR)、甲状腺转录因子-1(TTF-1)、癌胚抗原(CEA)、表面活性蛋白-B(Sp-B)、细胞角蛋白(CK)的表达情况。结果用免疫组化方法确定56例胸膜上皮性恶性肿瘤中恶性间皮瘤24例,转移性肺腺癌22例。波形蛋白、MC、CR、TTF-1、CEA、Sp-B在恶性间皮瘤与转移性肺腺癌中表达差异具有显著性(P<0.001或P<0.002)。结论用免疫组化方法鉴别胸膜恶性间皮瘤与转移性肺腺癌,波形蛋白、MC、CR、TTF-1、CEA、Sp-B是较为理想的标志物。Background and objective It is difficult to distinguish epithelial malignant tumors in the pleura. The purpose of this paper is to explore the role of immunohistochemistry in distinguishing malignant mesothelioma from lung adenocarcinoma in the pleura. Methods S-P immunohistochemical method was used to detect expression of vimentin, mesothelial cell (MC), calretinin (CR), thyroid transcription factor-1 (TTF-1), carcino-embryonic antigen (CEA), surfactant protein-B (Sp-B) and cytokeratin (CK) in 56 cases of epithelial malignant tumors in the pleura. Results In 56 cases of epithelial malignant tumors in the pleura, 24 cases of malignant mesothelioma and 22 cases of lung adenocarcinoma were ascertained, the source of 8 cases of metastatic adenocarcinoma was not known and the other 2 cases of tumor were difficult to be distinguished. The expression of vimentin, MC, CR, TTF-1, CEA, Sp-B between mesothelioma and adenocarcinoma was significantly different (P<0.001 or P<0.002) (t value was 4.90, 4.85, 3.50, 9.03, 8.58, 3.49 respectively). CK positive expression was seen in all 13 cases of malignant mesothelioma and 5 cases of lung adenocarcinoma. Conclusion Vimentin, MC, CR, TTF-1, CEA, Sp-B are ideal markers in distinguishing malignant mesothelioma from lung adenocarcinoma in the pleura by using immunohistochemical method.

关 键 词：胸膜肿瘤 恶性间皮瘤 肺肿瘤 免疫组织化学 鉴别诊断 

分 类 号：R734.3[医药卫生—肿瘤] R734.2[医药卫生—临床医学]