恶性胸水细胞蜡块在肺癌诊断及治疗中的应用研究  

Application of malignant pleural fluid cell wax mass in diagnosis and treatment of lung cancer

作　　者：郭业兵 王木森 高菲 GUO Yebing;WANG Musen;GAO Fei(Dong'e County People’s Hospital,Liaocheng 252200,Shandong)

机构地区：[1]东阿县人民医院,山东聊城252200

出　　处：《菏泽医学专科学校学报》2022年第1期1-4,共4页Journal of Heze Medical College

摘　　要：目的探讨恶性胸水细胞蜡块在肺癌诊断、组织学分型及EGFR/ROS1/ALK及PD-L1检测中的价值。方法制备细胞蜡块行HE染色,选取不同的免疫组化抗体进行标记,结合组织学形态及免疫组化表达对其进行分型,对确诊的肺腺癌的标本,行EGFR/ROS1/ALK及PD-L1检测。结果429例样本中查见癌细胞138例,肺腺癌97例,小细胞癌10例,鳞状细胞癌3例,粘液表皮样癌1例,乳腺癌6例,胃癌4例,卵巢癌3例,子宫浆液性癌1例,子宫癌肉瘤1例,骨髓瘤1例,胆管癌1例,未知来源10例。对确诊的84例肺腺癌行EGFR/ROS1/ALK检测,EGFR突变率为63.1%(53/84例)、ROS1融合突变率1.19%(1/84例)、ALK突变率3.57%(3/84例)。PD-L1共检测5例,阳性表达率40%(2/5例)。结论胸水细胞蜡块结合免疫组化有助于肿瘤的组织学类型诊断,可行基因检测为肺癌患者精准化的治疗提供依据。Objective To explore the value of malignant pleural fluid cell wax mass in the diagnosis of lung cancer,histological classification and detection of EGFR/ROS1/ALK and PD-L1.Methods Cell blocks were prepared for HE staining,and different immunohistochemical antibodies were labeled,and they were classified based on histological morphology and immunohistochemical expression.EGFR/ROS1/ALK and PD-L1 tests were performed for confirmed cases of lung cancer.Results Among the 429 samples,cancer cells were detected in 138 cases,including 97 cases of lung cancer,10 cases of small cell cancer,3 cases of squamous cell cancer,1 cases of mucoepidermoid cancer,6 cases of breast cancer,4 cases of gastric cancer,3 cases of ovarian cancer,1 case of uterine serous carcinoma,1 case of uterine cancer,1 case of myeloma,1 case of cholangiocarcinoma,and 10 cases of unknown origin.The EGFR/ROS1/ALK gene tests were detected in 84 cases of lung cancer.The EGFR gene mutation rate was 63%(53/84),ROS1 fusion mutation rate was 1.2%(1/84)and ALK mutation rate was 3.4%(3/84).PD-L1 was detected in 5 cases,and the positive expression rate was 40%(2/5).Conclusion Pleural fluid cell block combined with immunohistochemistry is helpful for histological type diagnosis of cancer,and gene detection can provide basis for precise treatment of lung cancer.

关 键 词：恶性胸水细胞 免疫组织化学 EGFR ROS1 ALK PD-L1 

分 类 号：R446[医药卫生—诊断学]