免疫细胞化学鉴别良恶性体腔积液的抗体选择和组合  

Antibody selection and combination in benign and malignant body cavity effusions with logistic regression

作　　者：邬万新[1] 唐正英[1] 张燕萍[1] 钱建育[1] 王振[1] 温晓伟[1] 陆宁[1] 

机构地区：[1]浙江省嘉兴学院附属第一医院病理科,嘉兴314000

出　　处：《实用肿瘤学杂志》2006年第5期365-368,共4页Practical Oncology Journal

基　　金：浙江省卫生医药科技计划项目(2003B153)

摘　　要：目的优化免疫细胞化学鉴别良、恶性体腔积液的抗体选择和组合。方法对病理学诊断明确的67例恶性和22例良性体腔积液标本采用石蜡细胞块和免疫细胞化学技术检测13种抗体。单因素方法分析每个抗体的敏感性和特异性。Logistic回归分析不同抗体组合对良、恶性体腔积液诊断的准确性。结果检测体腔积液内肿瘤细胞敏感性最高的抗体是E-cadherin,为85.1%。其次是BerEP4和CK7,敏感性分别为82.1%和80.6%。检测肿瘤细胞特异性最强的抗体是E-cadherin、BerEP4和CK20,特异性均达到100%。Calretinin检测间皮细胞的敏感性和特异性分别为100%和95.5%,Desmin检测间皮细胞的敏感性和特异性分别为90.9%和100%。Logistic回归分析显示Calretinin是统计学上判断良、恶性体腔积液最佳的单个抗体,Calretinin和E-cadherin是区分良、恶性体腔积液最有效率的抗体组合。结论结合单因素和多因素分析结果,我们推荐E-cadherin、BerEP4、Calretinin和Desmin作为日常免疫细胞化学鉴别良、恶性体腔积液的抗体组合。Objective To optimize the antibody selection and combination of immunocytochemistry in differentiating between benign and malignant effusions. Methods We checked 13 antibodies in 67 cases of malignant and 22 cases of benign effusion specimens with paraffin - embedding cell blocks and immunocytochemistry. The diagnosis of malignant effusions was verified by histopathology. The sensitivity and specificity of antibodies were determined. The diagnostic validity of antibody panels for differentiating between benign and malignant effusions was analyzed with logistic regression. Results The most sensitive antibody for identifying tumor cells in effusions was E - cadherin with sensitivity of 85.1%, following by BerEP4 and CK7 with the sensi- tivity of 82.1% and 80.6%, respectively. Antibodies with the specificity of 100% for tumor cells in effusion were E - cadherin, BerEP4 and CD20. The sensitivity for mesothelial cells of calretinin and desmin were 100% and 90.9% respectively; The specificity for mesothelial cells of calretinin and desmin were 95.5 % and 100% respectively. The logistic regression analysis demonstrated calretinin was the most powerful factor for differentiating between benign and malignant effusions. The panel of E - cadherin and calretinin was the most efficient combination to distinguish malignant effusions from benign effusions. Conclusion With the results of univariate and multivariate analysis, we recommend a panel of E - cadherin, BerEP4 , calretinin and desmin for immunoytocbemically differentiating between benign and malignant effusions.

关 键 词：体腔积液 细胞学 免疫细胞化学 LOGISTIC回归 

分 类 号：R446.8[医药卫生—诊断学] R446.6[医药卫生—临床医学]