细胞量少的卵巢癌腹腔液漏诊和过度诊断的实验分析  

Experimental analysis about missed diognosis and over diagnosis on peritoneal fluids of ovarian cancer with few cells

作　　者：邢宝玲[1] 葛素梅[1] 焦练 郭存存[1] 强贤[1] 欧阳俊[1] 夏伟[1] 

机构地区：[1]南京医科大学附属常州市妇幼保健院病理科,213003

出　　处：《临床与实验病理学杂志》2016年第11期1223-1227,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：常州市科技计划资助(CJ20159040)

摘　　要：目的探讨细胞量少的卵巢癌腹腔液的漏诊及过度诊断情况及原因。方法建立卵巢癌腹水模型,分阴性组和4个阳性组,即4 ml良性腹腔冲洗液中有0、5、10、20、40个卵巢癌SKOV3细胞,每组重复3次,以观察HE和免疫细胞化学染色切片、磁激活细胞分选(magnetic activated cell sorting,MACS)联合流式细胞鉴定的方法检测该模型。结果判断阴性组的样本中无癌细胞,部分阳性组样本中有癌细胞;Ep CAM、Calretinin均阳性,Pax-8、CK5/6部分阳性;5组中均有EBA-1免疫荧光阳性的上皮细胞,阳性率分别为13.6%、6.7%、9.0%、6.2%、6.3%。结论卵巢癌腹腔液中的细胞量少时,形态学观察癌细胞易造成漏诊,免疫细胞化学染色易出现假阳性,MACS不能有效分离其中的癌细胞,应采用新方法以识别分离腹腔液中的少量癌细胞。Purpose To investigate the status of missed diagnosis and over diagnosis on peritoneal fluids of ovarian cancer with few cells and to discuss the causes. Methods Firstly, the model of peritoneal fluids of ovarian cancer was built including the negative control group and four positive groups by adding 0, 5, 10, 20, 40 ovarian cancer SKOV3 cells into 4 ml benign peritoneal washings re- spectively. HE staining and immunocytochemistry staining slides made from the model were observed. Magnetic activated cell sorting combined with flow cytometry was used to identify this model. Results Three pathologists found that there were no cancer cells in all specimens of the negative group, one or more cancer cells in some specimens of the positive groups. EpCAM and Calretinin were posi- tive in all the specimens, and Pax-8 and CK5/6 were positive in some of the specimens. With immunofluorescerce te~： EBA-1 was pos- itive in five groups （ 13.6%, 6. 7%, 9.0%, 6. 2%, 6. 3% ）. Conclusion If cells in peritoneal fluids of ovarian cancer are few, cancer cells are missed easily with morphologic assay, false positive results are got easily with immunocytochemistry test, and MACS can not sort cancer cells effectively from the fluids. So, it is reasonable to develop new technology to sort and identify few cancer cells from peritoneal fluids of ovarian cancer.

关 键 词：卵巢肿瘤 腹腔液 癌细胞 磁激活细胞分选 流式细胞术 

分 类 号：R737.3[医药卫生—肿瘤]