组合性抗体检测在转移性肺腺癌与胸膜恶性间皮瘤鉴别诊断中的应用  

Application of combinatorial antibody detection in differential diagnosis of metastatic lung adenocarcinoma from malignant pleural mesothelioma

作　　者：魏亚敏[1] 郑锦花[1] 马秦榕 钟玲玲[1] 胡洁[1] 金美华[1] WEI Yamin , ZHENG Jinhua , MA Qinrong , et al(Department of Pathology, Affiliated Hospital, Guilin Medical School, Guilin 541001, CHIN)

机构地区：[1]桂林医学院附属医院病理科,广西541001

出　　处：《江苏医药》2018年第3期260-263,I0002,共5页Jiangsu Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S201601);桂林市科学研究与技术开发计划项目(2016012706-8)

摘　　要：目的探讨组合性抗体检测在鉴别诊断转移性肺腺癌和胸膜恶性间皮瘤中的应用价值。方法采用常规涂片法和免疫组化法检测60例患者胸水样本;免疫组化检测癌胚抗原(CEA)、甲状腺转录因子1(TTF-1)、天冬氨酸蛋白酶A(Napsin A)、间皮细胞(MC)、钙网膜蛋白(CR)、细胞角蛋白5/6(CK5/6)、广谱细胞角蛋白(p-CK)和CK7的表达。结果常规涂片法诊断转移性肺腺癌35例,恶性肿瘤细胞6例及可疑恶性肿瘤细胞19例;免疫组化染色后诊断为转移性肺腺癌53例和胸膜恶性间皮瘤7例。TTF-1、Napsin A、CEA、CK7和p-CK在转移性肺腺癌组织中阳性表达,MC、CR及CK5/6在胸膜恶性间皮瘤组织中阳性表达,免疫组化组合性抗体检测法鉴别诊断优于常规涂片法(P<0.05)。结论组合性抗体检测在转移性肺腺癌和胸膜恶性间皮瘤鉴别诊断方面具有一定临床优势。Objective To explore the application value of combinatorial antibody detection in the differential diagnosis of metastatic lung adenocarcinoma from malignant pleural mesothelioma.Methods Hydrothorax samples of 60 cases were examined with cytological smears and immunohistochemistry.The combinatorial antibodies used for staining of immunohistochemistry included carcino-embryonic antigen（CEA）,thyroid transcription factor 1（TTF-1）,Napsin A,mesothelial cell（MC）,calretinin（CR）,cytokeratin（CK）5/6,pan-cytokeratin（p-CK）and CK7.Results The diagnoses of cytological smears were adenocarcinomas in 35 cases,malignant cells in 6 cases and undefined cells in 19 cases,which of immunohistochemistry were metastatic lung adenocarcinoma in 53 cases and malignant pleural mesothelioma in 7 cases.The TTF-1,Napsin A,CEA,CK7 and p-CK were positively expressed in metastatic lung adenocarcinoma.The MC,CR and CK5/6 were positively expressed in malignant pleural mesothelioma. The combinatorial antibody detection of immunohistochemistry was superior to conventional cytological smears in differential diagnosis（P〈0.05）.Conclusion Combinatorial antibody detection has a certain clinical advantage in differential diagnosis of metastatic lung adenocarcinoma from malignant pleural mesothelioma.

关 键 词：转移性肺腺癌 胸膜恶性间皮瘤 组合性抗体 鉴别诊断 

分 类 号：R446[医药卫生—诊断学]