癌胚抗原、上皮膜抗原、波形蛋白对胸腹水良恶性细胞鉴别研究  

The research of identification for Carcinoembryonic antigen, epithelial membrane antigen, vimentin of Benign and malignancy in pleural effusion

作　　者：杨菊 

机构地区：[1]上海市第五人民医院病理科,200240

出　　处：《中国医疗前沿》2013年第4期15-16,共2页China Healthcare Innovation

摘　　要：目的研究癌胚抗原(CEA)、上皮膜抗原(EMA)及波形蛋白(vimentin)对胸腹水细胞学鉴别诊断的意义。方法选择我院2010年12月-2012年4月收治的70例胸腹水患者为研究对象,分为良性组33例与恶性组37例,采用免疫细胞化学SP法分别检测癌胚抗原、上皮膜抗原、波形蛋白于细胞内的表达,使用图像分析定量测定脱落细胞的核面积,浆面积及核浆比,细胞周长,平均直径,及圆度、形状因子。结果恶性组患者的腺癌细胞CEA表达均呈阳性,EMA呈部分阴性,vimentin均为阴性;良性组的CEA表达均为阴性,BMA,Vimentin呈部分阳性。恶性组患者腺癌细胞的核面积,浆面积,核浆比,细胞周长,平均直径以及形状因子均高于增生性间皮细胞,但两组细胞圆度无显著差异性(P>0.05)。CEA的灵敏度为60.54%,特异度98.2%,约登指数0.57,准确度79.3%;EMA的灵敏度48.38%,特异度87.45%,约登指数0.31,准确度66.85%;vimentin灵敏度64.1%,特异度87.5%,约登指数0.51,准确度为75.41%。三者联合检测的诊断价值高于单独检测。结论利用免疫细胞化学鉴别良恶性胸腹水具有较高的临床价值,通过将癌胚抗原,上皮膜抗原,波形蛋白三者结合进行定量分析,可以提高胸腹水细胞学诊断的阳性率及准确性。Objective To study carcinoembryonic antigen（CEA）, epithelial membrane antigen（EMA） and vimentin on the Neural effusion cytology differential diagnosis significance. Methods Choose from December 2010 to April 2012 of 70 cases of hospitalized patients with Neural effusion as the research object, the benign group 33 cases, malignant group of 37 cases, using immunocytoehemistry sp method, testing carcinoembryonic antigen in the expression of the body, the use of image analysis quantitative determination exfoliated ceils of the nuclear area, plasma area level nucleoplasm ratio, cells perimeter, average directly, and roundness, shape factor. Results Malignant patients gland cancer ceils CEA expression are positive, EMA is part of the negative, vimentin, are negative, Benign group of CEA expression are negative, EMA, Vimentin is part of the positive. Malignant patients gland cancer cell nuclear area, plasma area, nucleoplasm ratio, ceils perimeter, average diameter and shape factor are higher than the hyperNastic mesothelium cell, but two groups of ceils roundness no significant difference（P〉0.05）. The sensitivity of CEA for 60.54%, specific degree 98.2%, about an index of 0.57, 79.＇3% accuracy The EMA＇s sensitivity 48.38%, specific degree 87.45%, about an index of 0.31, 66.85% accuracy, Vimentin sensitivity 64.1%, specific degree 87.5%, about an index of 0.51 and the accuracy is 75.41%. The combined detection, diagnosis value higher than single detection. Conclusion Using immunocytochemistry differential diagnosis of malignant belly good water has high clinical value, through the will carcinoembryonic antigen, epithelial membrane antigen, waveform protein with three quantitative analysis, we can improve the Neural effusion positive diagnosis rate.

关 键 词：免疫细胞学 胸腹水 肿瘤 胸腔积液 

分 类 号：R361.3[医药卫生—病理学]