胸膜上皮型恶性间皮瘤临床病理特征及相关抗体研究  

CLINICAL PATHOLOGICAL CHARACTERISTICS AND THE RELATED ANTIBODY OF PLEURAL EPITHELIAL MALIGNANT MESOTHELIOMA

作　　者：邢荣格[1] 张晓玲[1] 周玮玮[1] 张欣[1] 苗玉[1] 田亮[1] 

机构地区：[1]河北医科大学附属沧州市中心医院病理科,河北省沧州市061001

出　　处：《中国煤炭工业医学杂志》2016年第1期64-68,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省沧州市科技计划项目(编号:09ZD68)

摘　　要：目的探讨胸膜上皮型恶性间皮瘤的临床病理特征及免疫组化表达。方法回顾性分析2009年1月—2013年12月56例经病理证实的胸膜上皮型恶性间皮瘤患者的临床资料。应用免疫组化S-P法检测CK5/6、CK8/18、CEA、TTF1、MC、Cal、D2-40、NapsinA的表达水平。结果56例间皮瘤患者中,46例有明确石棉接触史,临床表现胸痛24例,胸腔积液38例,胸闷憋气47例;双侧弥漫增厚型9例,单侧局限型47例,粟粒结节型42例,局部肿块型5例。随访45例,双侧弥漫型生存期3~6个月,局限型生存期均〈2年,平均生存期8个月。病理类型全部为上皮型,免疫组化阳性表达率分别为CK5/6（100%）、CK8/18（98%）、D2-40（98%）、Cal（95%）、MC（93%）、CEA（3.5%）、NapsinA（0%）、TTF1（0%）。结论本组恶性间皮瘤患者的发病与石棉接触密切相关,呈上皮型病理特征。CK5/6、CK8/18、CEA、TTF1、MC、Cal、D2-40、Napsin A联合检测能够解决胸膜上皮型恶性间皮瘤的诊断和鉴别诊断问题。Objective To investigate the immunohistochemical expression and clinical pathological features of the malignant pleural epithelial mesothelioma.Methods Retrospective analysis of the clinical information of 56 patients which were pathologically proved to be malignant pleural epithelial mesothelioma from January 2009 to December 2013.The expression of CK5/6,CK8/18,CEA,TTF1,MC,Cal,D2-40,Napsin A was detected by immunohistochemical methods.Results Totally46 cases of 56 the mesothelioma patients had a clear history of exposure to Asbestos,clinical manifestations of chest pain in24 cases,pleural effusion in 38 cases,chest distress in 47 cases;bilateral diffuse thickening type in 9 cases,unilateral limited type in 47 cases,42 cases of miliary nodular type,5 cases of local mass type.Finally,45 cases was followed up,the survival period of patients with bilateral diffuse type was 3~6 months,patients with localized was less than2 years,the average survival period was 8 months.All cases were epithelial type,the positive expression rates were CK5/6（100%）,CK8/18（98%）,D2-40（98%）,Cal（95%）,MC（93%）,CEA（3.5%）,NapsinA（0%）,TTF1（0%）,respectively.Conclusion The morbidity of malignant mesothelioma is associated with Asbestos exposure,whose pathological features are epithelial type.Joint detection of CK5/6,CK8/18,CEA,TTF1,MC,Cal,D2-40 and Napsin A can diagnosis and differential diagnosis of pleural epithelial malignant mesothelioma.

关 键 词：胸膜 上皮型恶性间皮瘤 临床病理特征 免疫组织化学 

分 类 号：R734.3[医药卫生—肿瘤]