细胞蜡块联合免疫组化及基因检测诊断恶性心包积液的价值  

Diagnostic Value of Cell Wax Block Combined With Immunohistochemistry and Gene Detection in Diagnosis of Malignant Pericardial Effusion

作　　者：王丽菊 翁剑鸣[1] 郑春暖 WANG Liju;WENG Jianming;ZHENG Chunnuan(Department of Pathology,Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou Fujian 363000,China)

机构地区：[1]福建省漳州市医院病理科,福建漳州363000

出　　处：《中国卫生标准管理》2023年第6期88-91,共4页China Health Standard Management

摘　　要：目的探讨细胞蜡块结合免疫组化在心包积液肿瘤转移病理诊断的应用价值。方法选取恶性心包积液标本70例,均为福建省漳州市医院病理科2019年1月—2022年7月所收集,选择相应抗体开展免疫组化分析。分别通过逆转录聚合酶链反应(reversetranscription polymerase chain reaction,RT-PCR)、实时荧光定量聚合酶联反应(quantitative Real-time PCR,qRT-PCR)对肺腺癌来源的标本中棘皮动物微管相关样蛋白4-间变性淋巴瘤激酶(echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase,EmL4-ALK)融合基因情况、表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变情况进行分析。结果全部70例恶性心包积液标本经细胞蜡块结合免疫组化染色分析,56例患者为腺癌,6例为小细胞癌,7例患者为鳞状细胞癌,1例患者为恶性间皮瘤;其中56例腺癌的具体来源情况为:26例来源于肺,8例来源于乳腺,13例来源于消化道,另外9例来源于卵巢。26例肺腺癌中,出现EGFR基因突变的患者共有9例,其中4例患者属于19del突变,5例患者属于L858R突变,除此之外出现EmL4-ALK融合基因的患者有1例,另外16例患者并没有发生EmL4-ALK融合基因以及EGFR基因突变。结论临床中在对恶性心包积液进行诊断时,应用细胞蜡块结合免疫组化检测不但能准确判断肿瘤分型,而且还能明确肿瘤起源,进而为制定有针对性的治疗方案提供依据。Objective To explore the application value of cell wax block combined with immunohistochemistry in the pathological diagnosis of pericardial effusion tumor metastasis.Methods A total of 70 samples of malignant pericardial effusion were collected from the department of pathology,Zhangzhou Municipal Hospital of Fujian Province,from January 2019 to July 2022.The corresponding antibodies were selected for immunohistochemical analysis.The fusion gene of echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase(EmL4-ALK analysis of mutations of epidermal growth factor receptor(EGFR)gene.Results All 70 samples of malignant pericardial effusion were analyzed by cell wax and immunohistochemical staining.A total of 56 patients were adenocarcinoma,6 patients were small cell carcinoma,7 patients were squamous cell carcinoma,and 1 patient was malignant mesothelioma;The specific sources of 56 cases of adenocarcinoma are:26 cases from the lung,8 cases from the breast,13 cases from the digestive tract,and 9 cases from the ovary.Among the 26 cases of lung adenocarcinoma,there were 9 patients with EGFR gene mutation,including 4 patients with 19del mutation,5 patients with L858R mutation,1 patient with EmL4-ALK fusion gene,and the other 16 patients without EmL4-ALK fusion gene and EGFR gene mutation.Conclusion In the clinical diagnosis of malignant pericardial effusion,the application of cell wax block combined with immunohistochemistry can not only accurately determine the tumor type,but also clarify the origin of the tumor,thus providing a basis for formulating targeted treatment plans.

关 键 词：心包积液 细胞蜡块 病理诊断 免疫组化 基因检测 应用价值 

分 类 号：R561[医药卫生—呼吸系统]