弹力纤维及广谱型角蛋白双重染色与单纯弹力纤维染色在肺癌可疑胸膜侵犯病例中的比较  

Comparison of double staining of elastic fibers and broad-spectrum keratin with simple elastic fiber staining in cases of suspected pleural invasion of lung cancer

作　　者：王敏[1] 平国强[1] 张炜明[1] 宋国新[1] WANG Min;PING Guo-qiang;ZHANG Wei-ming;SONG Guo-xin(Department of Pathology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院病理科,南京210029

出　　处：《临床与实验病理学杂志》2018年第6期650-654,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的比较弹力纤维及广谱型角蛋白双重染色与单纯弹力纤维染色评估肺癌胸膜侵犯的效果。方法回顾性分析江苏省人民医院2015年6月~2016年7月经术后病理证实为肺癌病例的临床病理资料,选取HE染色后不能明确是否侵犯胸膜的104例使用弹力纤维及广谱型角蛋白双重染色和单纯弹力纤维染色进行病理分析。结果 104例患者中,使用单纯维多利亚蓝染色分析胸膜侵犯阳性患者46例,而使用双重染色法分析胸膜侵犯阳性患者63例,采用双重染色法评估胸膜侵犯阳性率高于单纯弹力纤维染色(P<0.05)。进一步病理学观察发现,使用双重染色法与单纯弹力纤维染色法分析结果矛盾的患者,大部分为单个或数个广谱角蛋白染色阳性的肿瘤细胞突破胸膜。结论相对于单一方法染色,弹力纤维及广谱型角蛋白双重染色结合了两者的优点并可同步显像胸膜及肿瘤细胞,能更好的观察肿瘤细胞与周围胸膜之间的毗邻关系,对于明确病理诊断及制定临床治疗方案具有积极意义。Purpose To evaluate the effects of double staining of elastic fibers and broad-spectrum keratin and simple elastic fiber staining in pleural invasion of lung cancer.Methods The pathological data of lung cancer from June 2015 to July2016 in Jiangsu Province Hospital were retrospectively analyzed,of which 104 cases presented with suspected pleural invasion by HE staining.Double staining of elastic fibers and broad-spectrum keratin and simple elastic fiber staining were adopted to compare their effects for pathological analysis on pleural invasion of lung cancer.Results 46 patients with positive pleural invasion were reported by simple elastic fiber staining,whereas 63 patients with positive pleural invasion were detected by double staining.The positive rate of double staining was 60.58%,however the positive rate of simple elastic fiber staining was44.23%.The ability of double staining on detection of pleural invasion was significantly higher than simple elastic fiber staining.Furthermore,following pathological analysis revealed that patients with contradictory results using double staining and simple staining were mostly diagnosed by presence of single or several broad-spectrum keratin-positive tumor cells which invaded the pleura.Conclusion Compared with simple elastic fiber staining,double staining of elastic fibers and broad-spectrum keratin combines the advantages of these two methods,which can simultaneously visualize the pleural and tumor cells,so as to better observe the adjacent relationship between tumor cells and surrounding pleura.Double staining of elastic fibers and broadspectrum keratin is an efficient method for pathological diagnosis and benefit to following clinical treatment of patients with positive pleural invasion of lung cancer.

关 键 词：肺肿瘤 弹力纤维染色 广谱角蛋白染色 胸膜转移 

分 类 号：R734.2[医药卫生—肿瘤]