非小细胞肺癌胸腔积液细胞块分子病理检测的意义  

Significance of non-small cell lung cancer pleural effusion cell blocks in molecular pathological detection

作　　者：张缨[1] 李祥周[1] 周瑜[1] 梅佳[1] 曹晓卉[1] 

机构地区：[1]解放军第八一医院病理科,南京医学硕士210002

出　　处：《医学研究生学报》2013年第8期829-832,共4页Journal of Medical Postgraduates

摘　　要：目的分子病理检测所选取的肿瘤组织通常经外科手术获得,这会对患者造成一定的创伤,且并不适用于晚期或复发转移的肿瘤患者。文中探讨以非小细胞肺癌(non-small cell lung cancer,NSCLC)胸腔积液细胞块作为肿瘤组织替代材料进行分子病理检测的临床意义。方法 30例NSCLC胸腔积液分层离心获取肿瘤细胞并制作成细胞块,应用免疫组化、荧光原位杂交(fluorescence in situ hybridization,FISH)、基因测序等方法对其进行研究。结果细胞块切片中肿瘤细胞丰富并保存部分组织学结构特征;免疫组织化学染色能够辅助肿瘤确诊及分型;表皮生长因子受体(epidermal growth factor recep-tor,EGFR)基因的FISH检测阳性率为33.33%(10/30例),6例为EGFR基因高多体性扩增,4例为EGFR基因扩增;基因突变检测率为26.67%(8/30例),19外显子突变6例,21外显子突变2例。结论胸腔积液细胞块对于晚期NSCLC的诊治具有重要的临床意义,可辅助肿瘤确诊分型,并有效指导肿瘤的分子靶向治疗。Objective The tumor tissues used in molecular pathological detection are usually got after surgery, which causes trauma and is not suitable for the terminal cancer patients or the recurrent and metastasis patients. The aim of this study was to explore significance of non small cell lung cancer （NSCLC） pleural effusion cell blocks in molecular pathological detection as tumor tissues re- placement materials. Methods Tumor cells from the pleural effusion in 30 NSCLC patients were got to make cell blocks through strati- fied centrifugal. Immunohistochemistry, fluorescence in situ hybridization （FISH） and gene sequencing methods were used in this study. Results The tumor cells of cell block section were rich and could keep part of histological structure. Immunohistochemistry staining could assist diagnosis and tumor parting. The FISH positive detection rate of epidermal growth factor receptor （EGFR） was 33.33% （ 10/30 cases） including 6 cases of high polysomy in 4 cases of amplification. The mutation rate of EGFR gene was 26. 67% （8/30）. 6 cases were detected in the exon 19. 2 cases were detected in the exon 21. Conclusion The NSCLC pleural effusion cell blocks are useful for the diag- nosis, which are helpful for the determination of the primary source of tumor, and may instruct the molecular targeted therapy.

关 键 词：非小细胞肺癌 胸腔积液 细胞块 免疫组化 荧光原位杂交 基因突变 

分 类 号：R446.8[医药卫生—诊断学]