胸腹水细胞块切片联合免疫组化病理诊断在胸腹水中的临床价值  

The clinical value of pleural effusion cell section combined with immunohistochemical pathology in the diagnosis of pleural effusion

作　　者：胡君程 叶承祖 苏瑜娇 HU Juncheng;YE Chengzu;SU Yujiao(Department of Pathology,Army Hospital of the 73rd Group of the Army,Xiamen,Fujian,361000,China)

机构地区：[1]陆军第七十三集团军医院病理科,福建厦门361000

出　　处：《当代医学》2023年第10期149-152,共4页Contemporary Medicine

摘　　要：目的探究胸腹水细胞块切片处理联合免疫组化病理诊断技术在胸腹水诊断中的临床价值。方法选取2019年1月至2021年8月本院送检的687例患者的胸腹水标本作为研究对象,分别对其开展细胞块切片处理联合免疫组化检查和常规细胞涂片联合免疫组化检查,比较两种检查方法的阳性检出率,分析细胞块切片处理联合免疫组化检查的敏感蛋白表达情况。结果两种检查方法阴性检出率比较差异无统计学意义;细胞块切片处理联合免疫组化的阳性检出率为78.17%,明显高于常规细胞涂片联合免疫组化的66.81%,不确定检出率为2.91%,明显低于常规细胞涂片结合免疫组化的14.85%,差异有统计学意义(P<0.05)。Wilm’s肿瘤基因-1(WT-1)、钙结合蛋白(CR)、细胞角蛋白5/6(CK5/6)、足细胞结蛋白(DES)阳性表达率最高,细胞角蛋白7(CK7)、上皮细胞表面糖蛋白(MOC-31)、整合素蛋白αv(CD51)、甲状腺转录因子-1(TTF-1)、BerEP4、癌胚抗原(CEA)阳性表达率最低;WT-1、CR、CK5/6、DES阴性表达率最高,CK7、MOC-31、CD51、TTF-1、BerEP4、CEA阴性表达率最低;WT-1、CR、CK5/6、DES不确定性表达率最高,CK7、MOC-31、CD51、TTF-1、BerEP4、CEA不确定性表达率最低。结论采用细胞块切片处理联合免疫组化对胸腹水标本进行检查,可尽早明确其原发病类型。Objective To explore the clinical value of pleural effusion cell section combined with immunohistochemical pathology in the diagnosis of pleural effusion.Methods The pleural effusion and ascites samples of 687 patients admitted to our hospital from January 2019 to August 2021 were selected as the research subjects,and the cell block section processing combined with immunohistochemistry and conventional cell smear combined with immunohistochemistry were performed,the positive detection rate of the two methods was compared,and the expression of sensitive protein was analyzed after pleural effusion cell section treatment combined with immunohistochemical examination.Results There was no significant difference in the negative detection rate between the two methods.The positive detection rate of pleural effusion cell section processing combined with immunohistochemistry was 78.17%,which was significantly higher than 66.81%of conventional cell smear combined with immunohistochemistry,and the uncertain detection rate was 2.91%,which was significantly lower than 14.85%of conventional cell smear combined with immunohistochemistry,and the differences were statistically significant(P<0.05).The positive expression rates of Wilms'tumor 1(WT-1),calretinin(CR),cytokeratin 5/6(CK5/6)and desmin(DES)were the highest,and the positive expression rates of Cytokeratin 7(CK7),epithelial specific antigen-31(MOC-31),thrombomodulin51(CD51),thyroid transcription factor-1(TTF-1),BerEP4 and carcino embryonic antigen(CEA)were the lowest.The negative expression rates of WT-1,CR,CK5/6 and DES were the highest,and the negative expression rates of CK7,MOC-31,CD51,TTF-1,BerEP4 and CEA were the lowest.The uncertain expression rates of WT-1,CR,CK5/6 and DES were the highest,and the uncertain expression rates of CK7,MOC-31,CD51,TTF-1,BerEP4 and CEA were the lowest.Conclusion The primary disease type can be identified as early as possible by pleural effusion cell section combined with immunohistochemical examination of pleural and ascites samples.

关 键 词：胸腹水细胞块切片处理 免疫组化病理诊断 

分 类 号：R561.3[医药卫生—呼吸系统]