腹腔积液细胞蜡块细胞来源及免疫细胞化学的诊断价值  

Cell block cytology and the diagnosis value of immunocytochemical staining in peritoneal effusion

作　　者：程凯[1] 涂频 周晓蝶 沈勤[1] 何燕[1] 石群立[1] 

机构地区：[1]解放军南京总医院/南京大学金陵医院病理科,南京210002

出　　处：《临床与病理杂志》2017年第11期2402-2406,共5页Journal of Clinical and Pathological Research

基　　金：解放军南京总医院院管课题(2016055)~~

摘　　要：目的:探讨腹腔积液细胞蜡块细胞来源并分析PAX8,ER,CDX-2和CDH17免疫染色的鉴别诊断价值。方法:回顾性分析解放军南京总医院/南京大学金陵医院病理科146例腹腔积液细胞蜡块归档样本病理资料,并进行免疫细胞化学染色检测PAX8,ER,CDX-2和CDH17的表达。结果:腹腔积液细胞蜡块中,可见卵巢癌转移35例,胃肠道腺癌转移21例,也可以见到肺癌、乳腺癌、淋巴瘤、恶性黑色素瘤等恶性肿瘤转移。PAX8和ER在卵巢癌中的阳性率均为97%,在其他样本中阳性率分别为0%和5%,差异具有统计学意义(χ~2=140.56,P<0.001;χ~2=116.65,P<0.001)。在21例胃肠道腺癌中,CDX-2及CDH17的阳性率分别为90%和71%;在其余的125例细胞蜡块样本中,可以检测到5例CDX-2表达及3例CDH17表达,差异具有统计学意义(χ2=97.88,P<0.001;χ~2=79.26,P<0.001)。结论:多种恶性肿瘤细胞可以转移至腹腔积液,其中卵巢癌最多,胃肠道腺癌次之;PAX8,ER,CDH17和CDX-2具有较好的鉴别诊断价值。Objective： To study the source of cells in the cell block deriving from peritoneal effusion and to analysis the value of PAX8, ER, CDX-2 and CDH17 in the differential diagnosis. Methods： The clinical and pathological data in 146 cases of archived peritoneal effusion cell blocks were retrospectively analyzed, and the expression of PAX8, ER, CDX-2 and CDH17 were detected by En Vision immunocytochemical technique. Results： There were 35 cases of ovarian carcinoma and 21 cases of gastrointestinal adenocarcinoma. In all the 146 cell blocks; besides, lung cancer, breast carcinoma, lymphoma and melanoma were found in these specimens. Both of the PAX8 and ER was detected in 97%（34/35） of all the 35 ovarian cell blocks, while the positive rate was 0% and 5% in the remaining samples, respectively. The positive rate in ovarian carcinomas was significant higher than the rest samples（χ~2=140.56, P〈0.001; χ~2=116.65, P〈0.001）. In all of the 21 gastrointestinal adenocarcinomas, the expression rate of CDX-2 and CDH17 was 90% and 71%, respectively; from the other 125 samples, we observed 5 cases express CDX-2 and 3 cases expressed CDH17. The expression rate in gastrointestinal adenocarcinomas was significant higher than the other samples（χ~2=140.56, P〈0.001; χ~2=116.65, P〈0.001）. Conclusion： Many malignant tumor cells have the ability to spread to peritoneal effusion, with ovarian carcinoma most common and gastrointestinal adenocarcinoma secondly; PAX8, ER, CDH17 and CDX-2 expressions are of great value in differential diagnosis.

关 键 词：细胞蜡块 腹腔积液 免疫细胞化学染色 

分 类 号：R361.2[医药卫生—病理学]