肿瘤标志物IHC染色联合弹力纤维染色诊断长径≤3 cm肺腺癌脏层胸膜侵犯的效果  

Efficacy of tumor markers IHC staining combined with elastic fiber staining for diagnosis ofvisceral pleural invasion in lung adenocarcinoma with maximum tumor diameter ≤ 3 cm

作　　者：解立武[1] 王晶[1] 步鹏[1] Xie Liwu;Wang Jing;Bu Peng(Department of Pathology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院病理科,太原030013

出　　处：《肿瘤研究与临床》2025年第3期172-176,共5页Cancer Research and Clinic

摘　　要：目的探讨肿瘤标志物免疫组织化学(IHC)染色与弹力纤维染色联合的5种双染法对肿瘤长径≤3 cm肺腺癌脏层胸膜侵犯(VPI)的诊断价值。方法回顾性病例系列研究。收集2016年1月至2021年1月于山西省肿瘤医院确诊的肿瘤长径≤3 cm肺腺癌VPI处石蜡包埋手术标本90例。分别采用甲状腺转录因子1(TTF1)+维多利亚蓝法+丽春红⁃苦味酸(V.G.)法、细胞角蛋白7(CK7)+间苯二酚⁃碱性品红法+V.G.法、AE1/AE3+Verhoeff法+V.G.法、AE1/AE3+醛品红法+橙黄G法、AE1/AE3+维多利蓝法+V.G法对标本进行双染色。按染色结果,将肿瘤侵犯超过脏层胸膜弹力纤维层和侵犯脏层胸膜间皮表面诊断为VPI阳性。比较5种肿瘤标志物IHC染色与弹力纤维染色联合的双染法染色情况以及诊断VPI阳性率。结果AE1/AE3+维多利亚蓝法+V.G.法中弹力纤维呈蓝绿色,肿瘤细胞的胞质呈棕色,胶原纤维呈红色,镜下三者对比清晰,能够直观地显示胸膜累犯处的微细结构。TTF1+维多利亚蓝法+V.G.法中弹力纤维呈蓝绿色,肿瘤细胞的胞核呈棕色,由于只显示胞核,部分区域显示不清,尤其累犯胸膜弹力纤维处;胶原纤维呈红色。CK7+间苯二酚⁃碱性品红法+V.G.法中弹力纤维呈紫色或黑紫色,肿瘤细胞的胞质呈棕色,胶原纤维呈红色;紫色或黑紫色弹力纤维容易与黑色的沉积炭沫混合,不易识别。AE1/AE3+Verhoeff法+V.G.法中弹力纤维呈黑色,也容易与黑色的沉积炭沫混合,不易识别;肿瘤细胞的胞质呈棕色,胶原纤维呈红色。AE1/AE3+醛品红法+橙黄G法弹力纤维呈紫红色,肿瘤细胞的胞质呈棕色,胶原纤维呈黄色;弹力纤维与胶原纤维可见共染现象,部分病例不易识别。AE1/AE3+维多利亚蓝法+V.G.法诊断VPI阳性率为97.8%(88/90),TTF1+维多利亚蓝法+V.G.法为73.3%(66/90),CK7+间苯二酚⁃碱性品红法+V.G.法为72.2%(65/90),AE1/AE3+Verhoeff法+V.G.法为58.9%(53/90),AE1/AE3+醛品红+橙黄G法为70.0%(Objective To explore the diagnostic value of 5 double staining methods for tumor markers immunohistochemistry(IHC)staining combined with elastic fiber staining for the visceral pleural invasion(VPI)in lung adenocarcinoma with the maximum tumor diameter≤3 cm.Methods A retrospective case series study was conducted.Ninety paraffin-embedded VPI surgical specimens of lung adenocarcinoma with the maximum tumor diameter≤3 cm diagnosed in Shanxi Province Cancer Hospital from January 2016 to January 2021 were collected.Thyroid transcription factor 1(TTF1)+Victoria blue method+ponceau picric acid(V.G.)method,cytokeratin 7(CK7)+resorcinol basic fuchsin method+V.G.method,AE1/AE3+Verhoeff method+V.G.method,AE1/AE3+aldehyde red method+orange G method,AE1/AE3+Victoria blue method+V.G.method were used to perform the double staining for specimens.According to the staining results,the tumor invading beyond the visceral pleural elastic fiber layer and invading the surface of visceral pleural mesothelium was diagnosed as VPI positive.The staining results and diagnostic positivity rates of VPI were compared among the 5 double staining methods for tumor markers IHC staining combined with elastic fiber staining.Results The elastic fibers of AE1/AE3+Victoria blue method+V.G.method were blue-green,the cytoplasm of tumor cells was brown,and the collagen fibers were red.The contrast among the three was clear under the microscope,which could more intuitively display the fine structure of pleural involvement.TTF1+Victoria blue method+V.G.method showed that the elastic fibers were blue-green,and the nuclei of tumor cells were brown.Due to the fact that only the nuclei were displayed,some areas were not clearly visible,especially at the site of recurrent pleural elastic fibers;the collagen fibers were red.CK7+resorcinol basic fuchsin method+V.G.method showed purple or black purple elastic fibers,brown cytoplasm of tumor cells,and red collagen fibers;purple or black purple elastic fibers were prone to mixing with deposited black carbon powd

关 键 词：肺肿瘤 腺癌 肿瘤侵润 胸膜 肿瘤标记 生物学 免疫组织化学 弹力纤维 染色与标记 

分 类 号：R734.2[医药卫生—肿瘤]