在肝脏穿刺组织病理诊断中免疫组化的应用价值体会  

Application value of immunohistochemistry in histopathologic diagnosis of liver puncture

作　　者：王惠国 WANG Hui-guo(Chaoyang Second Hospital,Chaoyang 122000,China)

机构地区：[1]辽宁省朝阳市第二医院,122000

出　　处：《中国实用医药》2023年第13期74-76,共3页China Practical Medicine

摘　　要：目的 探究在肝脏穿刺组织病理诊断中免疫组化的应用价值,旨在为临床实践提供理论依据。方法 88例肝脏肿瘤患者为研究对象,所有患者均经B超引导实施肝脏肿块穿刺,获取标本。取得标本放入中性缓冲甲醛(浓度为4%)中,并实施固定,再放置65℃恒温箱中,温度不可过高。使用苏木素伊红进行修复抗原并染色,对于染色的程度不能太深,在染色时切片需为湿润状态,染色后使用光镜观察。分析诊断结果。结果 88例肝脏肿瘤患者中,诊断出58例(65.91%)肝癌患者,18例(20.45%)肝内胆管细胞癌患者,8例(9.09%)转移性恶性肿瘤患者,4例(4.55%)血管瘤患者。58例肝癌患者中,细胞结构可见变异型性患者45例(77.59%),极易诊断与判断;变异型较小患者13例(22.41%),与良性疾病的鉴别存在困难。肝癌患者使用免疫组化诊断,肝细胞抗原(HepPar-1)阳性、模型硫酸肝素糖蛋白患者30例(51.72%),与手术病理诊断相似。肝内胆管细胞癌患者细胞角蛋白(CK)1、CK20、CK7均为阳性16例(88.89%),死亡8例(44.44%)。转移性恶性肿瘤患者均寻找到原发病灶。血管瘤患者均确诊,实施对症治疗。结论 对肝脏穿刺组织病理诊断中可使用免疫组化技术,有助于提高诊断准确率,对疾病的治疗具有重要意义,可广泛应用于临床。Objective To explore the application value of immunohistochemistry in histopathologic diagnosis of liver puncture,so as to provide theoretical basis for clinical practice.Methods 88 patients with liver tumor were studied,and all patients underwent ultrasound-guided puncture of liver masses to obtain specimens.The samples were placed in neutral buffer formaldehyde(concentration 4%) and fixed in 65℃ incubator,the temperature should not be too high.The antigen was repaired and stained with hematoxylin eosin,the staining should not be too deep,the section should be moist during staining,and the staining should be observed with light microscopy.The diagnostic results was analyzed.Results Among 88 patients with liver tumors,58 cases(65.91%)were with hepatocellular carcinoma,18 cases(20.45%) with intrahepatic cholangiocarcinoma,8 cases(9.09%) with metastatic malignancy,and 4 cases(4.55%) with hemangioma.Among 58 patients with hepatocellular carcinoma,45 cases(77.58%) showed variant cell structure,which was easy to diagnose and judge,and 13 cases(22.41%) showed lesser variant cell structure,which was difficult to differentiate from benign disease.Immunohistochemical diagnosis of hepatocellular carcinoma showed that 30 patients(51.72%) had positive hepatocyte paraffin antigen(HepPar-1) and model heparin sulfate glycoprotein,which was similar to surgical pathological diagnosis.16 cases(88.89%) of patients with intrahepatic cholangiocarcinoma were positive for cytokeratin(CK) 1,CK20,and CK7,and 8 cases(44.44%) died.The primary lesion was found in all patients with metastatic malignancies.All patients with hemangioma were diagnosed and symptomatic treatment was implemented.Conclusion Application of immunohistochemical technique in histopathologic diagnosis of liver cancer is helpful to improve the diagnostic accuracy,and is of great significance for the treatment of diseases,which can be widely used in clinic.

关 键 词：肝脏穿刺组织 病理诊断 免疫组化 肝脏肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]