SATB2、CK7、CK20及Ki-67在卵巢原发性黏液性肿瘤和转移性阑尾黏液性肿瘤中的表达及鉴别诊断意义  

Expression and differential diagnostic significance of SATB2,CK7,CK20,and Ki-67 in primary ovarian mucinous tumors and metastatic appendiceal mucinous tumors

作　　者：金天 袁静萍[3] 陈仲涛[2] 陈丽霞[4] Jin Tian;Yuan Jingping;Chen Zhongtao;Chen Lixia(Jinzhou Medical University,Jinzhou 121000,China;Department of Pathology,Renmin Hospital of Hanchuan City,Hanchuan 431600,China;Department of Pathology,Renmin Hospital of Wuhan University,Wuhan 430000,China;The Second Hospital of Huangshi City,Huangshi 435002,China)

机构地区：[1]锦州医科大学,锦州121000 [2]汉川市人民医院病理科,汉川431600 [3]武汉大学人民医院病理科,武汉430000 [4]湖北省黄石市第二医院,黄石435002

出　　处：《中国组织化学与细胞化学杂志》2024年第6期583-588,共6页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的探讨SATB2、CK7、CK20和Ki-67在卵巢原发性黏液性肿瘤与转移性阑尾黏液性肿瘤的鉴别诊断中的应用价值。方法收集2018—2023年诊断的卵巢原发性黏液性肿瘤29例和转移性阑尾黏液性肿瘤12例患者的临床病理资料,采用免疫组织化学染色检测CK7、CK20、SATB2、Ki-67的表达,并分析联合检测对诊断的敏感性和特异性的影响。结果卵巢原发性黏液性肿瘤中,CK7阳性率最高,CK20阳性率较低,SATB2阳性率最低。转移性阑尾黏液性肿瘤中,CK20和SATB2均为100%阳性,CK7阳性率为33.33%。CK7(+)SATB2(-)组合对卵巢原发性黏液性肿瘤的诊断敏感性最高(89.65%),CK7(-)SATB2(+)组合对转移性阑尾黏液性肿瘤的特异性最强(89.65%)。Ki-67在卵巢原发性黏液性肿瘤中的平均值低于5%的值较多;在转移性阑尾黏液性肿瘤中,大部分值高于50%。结论联合检测CK7、CK20、SATB2可显著提高卵巢黏液性肿瘤与转移性阑尾黏液性肿瘤的诊断准确性,降低误诊率。CK7(+)/CK20(-)/SATB2(-)提示卵巢原发性黏液性肿瘤,CK7(-)/CK20(+)/SATB2(+)提示转移性阑尾黏液性肿瘤。Ki-67对二者的鉴别也有一定价值,Ki-67值低于5%提示卵巢原发性黏液性肿瘤,超过50%则考虑转移性阑尾黏液性肿瘤。Objective To investigate the diagnostic value of SATB2,CK7,CK20,and Ki-67 in differentiating primary ovarian mucinous tumors from metastatic appendiceal mucinous tumors.Methods Clinical and pathological data were collected from 29 cases of primary ovarian mucinous tumors and 12 cases of metastatic appendiceal mucinous tumors diagnosed between 2018 and 2023.Immunohistochemical staining was used to detect the expression of CK7,CK20,SATB2,and Ki-67,and the sensitivity and specificity of the combined detection were analyzed.Results In primary ovarian mucinous tumors,the positivity rate of CK7 was the highest,followed by CK20 and SATB2.In metastatic appendiceal mucinous tumors,the positivity rates of CK20 and SATB2 were both 100%,while CK7 was positive in only 33.33%.The combination of CK7(+)and SATB2(-)showed the highest sensitivity(89.65%)for diagnosing primary ovarian mucinous tumors,while CK7(-)and SATB2(+)showed the highest specificity(89.65%)for diagnosing metastatic appendiceal mucinous tumors.The Ki-67 proliferation index was lower in primary ovarian mucinous tumors,with the most value below 5%.In contrast,the majority of values in metastatic appendiceal mucinous tumors were above 50%.Conclusion Combined detection of CK7,CK20,and SATB2 significantly improves the diagnostic accuracy and reduces misdiagnosis rates for both ovarian mucinous tumors and metastatic appendiceal mucinous tumors.The CK7(+)/CK20(-)/SATB2(-)profile is highly suggestive of primary ovarian mucinous tumors,while CK7(-)/CK20(+)/SATB2(+)is strongly indicative of metastatic appendiceal mucinous tumors.Ki-67 is also useful in differentiation,with values below 5%suggesting primary ovarian mucinous tumors and values above 50%supporting metastatic appendiceal mucinous tumors.

关 键 词：AT富集序列特异性结合蛋白2 KI-67 CK7 CK20 卵巢黏液性肿瘤 转移性阑尾黏液性肿瘤 免疫组织化学表型 

分 类 号：R730.2[医药卫生—肿瘤]