肺小细胞癌支气管镜活检的陷阱——附64例免疫组化研究  

The Pitfall of Transbronchial Lung Biopsy in the Small Cell Carcinoma——Attach 64 Cases Immunohistochemistry Research

作　　者：王银萍[1] 曲丽梅[1] 郝玉丹[2] 

机构地区：[1]吉林大学第一医院病理科,长春130021 [2]公主岭市中心医院病理科,公主岭133002

出　　处：《中国肺癌杂志》2009年第8期901-904,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的通过支气管镜获得的小细胞肺癌组织,极易造成组织挤压,形态不清,仅凭HE切片进行诊断容易误诊,因此充分应用免疫组化可以进行支气管镜活检小标本的小细胞癌、低分化鳞状细胞癌、非典型类癌、淋巴瘤的诊断和鉴别诊断。方法经支气管镜活检标本,在HE切片染色上诊断为肺癌,倾向小细胞癌的病例64例,进行免疫组化Ki-67、CD56、TTF-1、CgA、Syn、P63、CK5/6、LCA、34βE12的染色。结果64例中小细胞癌61例,非典型类癌2例,低分化鳞状细胞癌1例。结论小细胞癌、低分化鳞状细胞癌、非典型类癌、淋巴瘤在治疗方法不同,充分应用免疫组化可以进行诊断和鉴别诊断,从而可以减少误诊,规避医疗风险。Background and objective It is very difficult to make diagnosis on the HE section to small cell lung carcinoma by bronchoscopic and easy to make misdiagnosis, we can avoid this by using immunohistochemical staining to diagnose differentially among the small cell carcinoma, poorly differentiated squamous cell carcinoma, atypical form carcinoid and lymphoma. Methods 64 cases of lung biopsy by bronchoscopic were consistency with small cell carcinoma and stained by immunochemistry for Ki67, CD56, TTF-1, CgA, Syn, P63, CK5/6, LCA, 34βE12. Results For the 64 cases, we diagnosed 61 cases to the small cell carcinoma, 1 case to the poorly differentiated squamous cell carcinoma and 2 cases to the atypical carcinoid after IHC stain. Conclusion It is the different therapy among the small cell carcinoma, poorly differentiated squamous cell carcinoma, atypical form carcinoid and lymphoma, so we can identify the diagnosis and differential diagnosis with IHC thoroughly, accordingly decrease incidence ofmisdiagnosis.

关 键 词：肺肿瘤 免疫组化 支气管镜活检 

分 类 号：R734.2[医药卫生—肿瘤]