胸水细胞块鉴别肺及胸膜恶性肿瘤中免疫组织化学抗体的选择  

Immunocytochemical study of pleural fluid cell blocks in differential diagnosis from pulmonary maliglant tumors

作　　者：阮雅君 潘登 夏朝霞 

机构地区：[1]宁波市临床病理诊断中心,浙江宁波315020

出　　处：《实用肿瘤杂志》2013年第3期292-294,共3页Journal of Practical Oncology

摘　　要：目的综合评价相关免疫组织化学抗体在胸水细胞块中表达的特异性和敏感性及在肺及胸膜恶性肿瘤鉴别诊断中的应用价值。方法胸水常规脱落细胞诊断找到癌细胞的所有病例,经观察细胞无退变的新鲜标本制成细胞蜡块,常规HE切片中有足够肿瘤细胞,通过免疫组织化学PV-600法检测TTF-1、CK5/6、CK7、CEA、p63、D2-40、WT-1、Calretinin、CD56、Syn和CgA。结果 TTF-1在14例肺腺癌患者中均呈强阳性表达,其中12例CK7阳性表达;2例恶性间皮瘤D2-40、CK5/6、Calretinin呈阳性表达,其中1例WT-1阳性表达;1例肺鳞癌中CK5/6、p63呈阳性表达;2例转移性癌未表达上述抗体。结论 TTF-1、CK7、CEA,CK5/6、p63,D2-40、WT-1、Calretinin、CK5/6,CD56、Syn、CgA分别在肺腺癌、肺鳞癌、恶性间皮瘤、肺小细胞癌中表达有较高的敏感性和特异性,可作为胸水细胞块诊断区分肺癌类型及与恶性间皮瘤鉴别的首选抗体组合。Objective To study the values of immunocytochemistry staining by cell block sections in pleural effusion of patients with puhnonary and pleural malignant tumors. Methods The samples of malignant pleural effusions were collected and made into cell blocks. PV-600 immunohistochemical technique was used to detect the expression of TFF-1, CK5/6, CK7, CEA, p63, D2-40, WT-1, Calretinin,CD56,Syn and CgA. Results TTF-1 strongly expressed in 14/14 cases of pulmonary adenocareinoma, in which CK7 expressed in 12/14 cases. In 2 cases of malignant mesothelioma, D2-40, CK5/6, Calretinin were positively expressed, and WT-1 was positive in one case. CK5/6 and p63 were positively expressed in one case of pulmonary squamous cell carcinoma. All the antibodies were negative in 2 cases of metastasis carcinoma. Conclusions Comhined detection of TTF-1, CK7, CEA; CK5/6, p63 ; D2-40, WT-I , Calretinin, CK5/6; CD56, Syn, CgA shows a high specificity and sensitivity for primary pulmonary adenocarcinoma, pulmonary squamous cell carcinoma, mesothelioma and small cell carcinoma, which can he used as the routine primary antibodies for differential diagnosis of the primary origins of tumor cells in pleural fluid.

关 键 词：肺肿瘤 诊断 胸膜肿瘤 诊断 免疫组织化学 肿瘤标记 生物学 胸腔积液 诊断 鉴别 

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