免疫细胞化学检查在诊断脑膜癌病中的应用  

Immunocytochemistry examination in diagnosing meningeal carcinomatosis

作　　者：庄建华[1] 赵忠新[1] 黄坚[1] 赵瑛[1] 倪麟[2] 

机构地区：[1]第二军医大学附属长征医院神经内科,上海200003 [2]上海第二医科大学附属瑞金医院血细胞室

出　　处：《中华神经科杂志》2005年第11期701-703,共3页Chinese Journal of Neurology

摘　　要：目的探讨免疫细胞化学检查在脑膜癌病(MC)诊断中的作用。方法对13例MC患者的脑脊液标本21份分别进行常规脑脊液细胞学和免疫细胞化学检查,比较两种检查方法的阳性率。结果首次脑脊液检查阳性者常规脑脊液细胞学4例,而抗癌胚抗原(CEA)和抗上皮膜抗原(EMA)免疫细胞化学均为10例;总阳性率常规脑脊液细胞学为42.86%(9/21),抗CEA免疫细胞化学为80.95%(17/21),抗EMA免疫细胞化学为85.71%(18/21)。结论免疫细胞化学的敏感性高于常规脑脊液细胞学,可提高MC患者的早期确诊率。Objective To increase the sensitivity of cytologic detection of malignant neoplasms in cerebrospinal fluid （CSF）. Methods All 21 CSF specimens from 13 patients with definitive meningeal carcinomatosis were tested by routine cytologic and immunocytochemical examinations, respectively. The positive rates of these two examinations were compared. Results The initial positive of routine CSF cytology was 4 cases ,and both the initial positive of immunocytochemistry for anti-carcinoembryonic antigen （CEA） and anti-epithelial membrane antigen （EMA） were 10 cases. There was significant difference between the positive rate of routine CSF cytology and the positive rate of immunocytochemistry for anti-CEA （ P〈0.05 ）, but there was no significant difference between the positive rate of routine CSF cytology and the positive rate of immunocytochemistry for anti-EMA （ P〉0.05 ） after statistic analysis. The total positive rate of routine CSF cytology was 42.86% （9/21） and the total positive rate of immunocytochemistry for anti-CEA was 80. 95% （17/21）. There was a significant difference between the two rates （P〈0.05）. The total positive rate of immunocytochemistry for anti-EMA was 85.71% （18/21 ）, and also there was a significant difference between the positive rate of immunocytochemistry for anti-EMA and the positive rate of routine CSF cytology （P〈0.01 ）. Conclusion The sensitivity of immunocytochemical examination was superior to that of the routine cerebrospinal fluid cytologic examination in diagnosing the meningeal carcinomatosis.

关 键 词：免疫组织化学 脑膜肿瘤 癌胚抗原 CA-15-3抗原 

分 类 号：R739.4[医药卫生—肿瘤]