胸腔积液细胞块切片免疫组化染色技术对肺腺癌的诊断效果  

Effect of immunohistochemical staining of pleural effusion cell blocks in the diagnosis of lung adenocarcinoma

作　　者：张宏岩 ZHANG Hong-yan(Department of Pathology,Benxi Central Hospital,Benxi 117000,China)

机构地区：[1]辽宁省本溪市中心医院病理科,117000

出　　处：《中国实用医药》2021年第32期205-208,共4页China Practical Medicine

摘　　要：目的分析胸腔积液细胞块切片免疫组化染色技术对肺腺癌的诊断效果。方法90例胸腔积液患者,采集胸腔积液标本,分别进行常规细胞涂片和细胞块切片免疫组化染色技术检查。对比细胞块切片HE染色和细胞涂片HE染色对胸腔积液的诊断结果;常规细胞涂片和细胞块切片免疫组化染色技术的恶性胸腔积液诊断率;间皮细胞免疫组化指标(Desmin、WT-1、CK5/6)、肺腺癌免疫组化指标(BerEP4、TTF-1、CK17、CD15)染色结果。结果细胞块切片HE染色和细胞涂片HE染色对胸腔积液的诊断结果对比差异无统计学意义(P>0.05)。细胞块切片免疫组化染色技术的恶性胸腔积液诊断率明显高于常规细胞涂片,差异具有统计学意义(P<0.05)。经病理检查发现90例患者中40例为恶性,细胞块切片免疫组化染色技术诊断误诊2例,诊断准确率为95.24%(40/42)。肺腺癌患者细胞中CD15、CK17、TTF-1、BerEP4阳性表达率明显高于良性细胞、间皮肿瘤、不确定性细胞,差异具有统计学意义(P<0.05);良性细胞中Desmin、WT-1、CK5/6阳性表达率明显高于肺腺癌,差异具有统计学意义(P<0.05);肺腺癌患者细胞中Desmin、WT-1、CK5/6阳性表达率低于间皮肿瘤细胞,差异具有统计学意义(P<0.05)。结论胸腔积液采取细胞涂片联合细胞块切片免疫组化染色技术进行诊断,可为临床医生提供更多诊断参考依据。Objective To analyze the effect of immunohistochemical staining of pleural effusion cell blocks in the diagnosis of lung adenocarcinoma.Methods In 90 patients with pleural effusion,specimens of pleural effusion were collected and examined by conventional cell smear and immunohistochemical staining of cell blocks,respectively.The diagnostic results of HE staining of cell blocks and HE staining of cell smears for pleural effusion were compared.The diagnostic rate of malignant pleural effusion by immunohistochemical staining of conventional cell smears and cell blocks,and staining results of immunohistochemical indices of mesothelial cells(Desmin,WT-1,CK5/6),immunohistochemical indices of lung adenocarcinoma(BerEP4,TTF-1,CK17,CD15)were compared.Results There was no statistically significant difference between HE staining of cell blocks and HE staining of cell smears for pleural effusion(P>0.05).The diagnosis rate of malignant pleural effusion by immunohistochemical staining of cell blocks was significantly higher than that by conventional cell smears,and the difference was statistically significant(P<0.05).The pathological examination revealed that 40 case were malignant and 2 cases were misdiagnosed by immunohistochemical staining of cell blocks in 90 patients,with a diagnostic accuracy of 95.24%(40/42).The positive expression rates of CD15,CK17,TTF-1,and BerEP4 in cells of lung adenocarcinoma patients were significantly higher than those of benign cells,mesothelial tumors,and indeterminate cells,and the differences were statistically significant(P<0.05).The positive expression rates of Desmin,WT-1 and CK5/6 in benign cells were significantly higher than those in lung adenocarcinoma cells,and the difference was statistically significant(P<0.05).The positive expression rates of Desmin,WT-1 and CK5/6 in lung adenocarcinoma cells were lower than those in mesothelial tumor cells,and the difference was statistically significant(P<0.05).Conclusion The cell smear in combination with immunohistochemical staining of cell bl

关 键 词：胸腔积液 细胞块切片 免疫组化染色技术 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]