细胞蜡块技术在肿瘤诊断及分子分型中的应用价值  

Application value of cell block technique in tumor diagnosis and molecular typing

作　　者：宋艳芳 史晓兰 马青松[1] SONG Yan-fang;SHI Xiao-lan;MA Qing-song(Department of Pathology,Liaocheng Second People's Hospital(Shandong First Medical University Affiliated Liaocheng Second Hospital),Liaocheng 252600,China)

机构地区：[1]聊城市第二人民医院病理科(山东第一医科大学附属聊城二院),山东聊城252600

出　　处：《中华肿瘤防治杂志》2022年第11期839-844,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的 探讨细胞蜡块联合免疫组化在肿瘤诊断及鉴别诊断中的作用,分析细胞蜡块联合基因检测在肿瘤分子分型中的临床应用价值。方法 收集并分析2010-01-14-2020-12-25聊城市第二人民医院收治的7 465例肿瘤患者的临床病理资料,所有患者均行细胞学检查,并制作成细胞蜡块应用免疫组化检测。采用实时免疫荧光定量PCR法对其中43例确诊为恶性肿瘤的细胞蜡块进行EGFR/EML4-ALK/ROS1/BRAF 4种基因联合检测,最后与活体组织病理检查及手术切除组织病理学诊断结果进行对比分析。结果 超声引导下细针穿刺细胞学细胞蜡块(UG-FNAC CB)与手术切除组织病理诊断符合率为97.1%,CT引导下细针穿刺细胞学细胞蜡块(CG-FNAC CB)为92.5%,细针穿刺细胞学细胞蜡块(FNAC CB)为98.8%,脱落细胞学细胞蜡块(EC CB)联合免疫组化为98.4%,上述方法灵敏度和特异度与活体组织病理诊断差异无统计学意义,均P>0.05。43例有组织块对照的细胞蜡块基因检测结果显示,EGFR、EML4-ALK、ROS1和BRAF基因突变检测结果与组织块一致率分别为86.0%、90.7%、95.3%和97.7%。结论 细胞蜡块切片可结合免疫组化和基因检测应用于肿瘤的诊断、鉴别诊断和分子分型,以明确肿瘤的分子亚型及生物学特征,为临床制定合理的个体化治疗方案提供可靠的病理依据。Objective To study the role of cell block combined with immunohistochemistry in tumor diagnosis and differential diagnosis, and to analyze the clinical value of cell block combined with gene detection in tumor molecular classification.Methods The clinicopathological data of 7 465 patients with benign or malignant tumors were collected and analyzed.Cytological examination was performed on all patients, and cell blocks were made for immunohistochemistry.The combined detection of EGFR/EML4-ALK/ROS1/BRAF gene was carried out in 43 cases of cell parafin block diagnosed as malignant tumors by real-time immunofluorescence method.Finally, the results were compared with the biopsy pathological examination and the histoppathological diagnosis of surgical resection.Results Combined with IHC,the pathological diagnosis consistency between the four methods(UG-FNAC CB,CG-FNAC CB,FNAC CB,EC CB) and the surgically resected tissue were 97.1%,92.5%,98.8% and 98.4%,respectively.There were also no significant difference in sensitivity and specificity of the above methods.Among the 43 cases of CB with tissue blocks, EGFR,EML4-ALK,ROSI and BRAF mutation were found to be consistent with tissue blocks at 86.0%,90.7%,95.3% and 97.7%,respectively.Conclusion Cell block sections combined with immunohistochemistry and gene detection are applied to the diagnosis, differential diagnosis and molecular typing of tumors, to identify the molecular subtypes and biological characteristics of tumors, and provide a reliable pathological basis for the clinical development of a reasonable individualized treatment program.

关 键 词：细胞蜡块 肿瘤 免疫组化 基因检测 分子分型诊断 

分 类 号：R[医药卫生]