细胞块切片联合免疫组化在浆膜腔积液诊断中的应用
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摘要
目的探讨细胞块切片联合免疫组化在浆膜腔积液诊断中的价值。方法收集我院2010年2月至2017年11月的胸腹水标本126例。每例标本收集后立即行普通涂片与液基细胞学涂片,并行离心沉淀,细胞块石蜡包埋、切片及免疫细胞化学染色。结果与细胞块切片联合免疫组化相比,普通涂片联合免疫组化及液基细胞学涂片联合免疫组化的阳性率均不高,且差异具有统计学意义(P <0. 05)。普通涂片联合免疫组化、液基细胞学涂片联合免疫组化的不确定率分别为34.1%、23. 8%,均高于细胞块切片联合免疫组化的13.5%,且差异均具有统计学意义(P <0. 05)。细胞块切片联合免疫组化法的假阳性率低于普通涂片联合免疫组化法,而细胞块切片联合免疫组化法的假阴性率低于普通涂片联合免疫组化法及液基细胞学涂片联合免疫组化法,差异均具有统计学意义(P <0.05)。在恶性肿瘤组织中,三种方法检测显示TTF-1、CK7和CEA阳性率均较高,且分别在肺癌、子宫内膜癌和乳腺癌中检出率最高。结论细胞块切片联合免疫组化是判断浆膜腔积液良恶性的有效方法 ,TTF-1、CK7和CEA的抗体组合具有较高的应用价值。
Objective To explore the value of cell block combined immunohistochemistry in the diagnosis of serous cavity effusion. Methods 126 cases of hydro thorax and ascites were collected in our hospital from February 2010 to November 2017. In each case, common smear and liquid based cytology smear were performed simultaneously, and paraffin embedded, sliced and immunocytochemical staining was carried out in parallel centrifuge sediments. Results Compared with cell block preparation combined with immunohistochemistry, the positive rate of combined smear, immunohistochemistry and liquid based cytology smear combined with immunohistochemistry showed a significant difference, which was statistically significant(P <0.05). The uncertainty rate of smear combined with immunohistochemistry,liquid based cytology smear and immunohistochemistry was 34. 1 % and 23. 8%,respectively, which were both higher than those of cell block combined with immunohistochemistry(13.5%), and the differences were statistically significant( P <0.05). The false positive rate of cell block production combined with immunohistochemical method was lower than that of the common smear combined with immunohistochemical method and cell block production combined with the false negative rate was lower than that of the ordinary smear combined with immunohistochemical method and liquid based cytology combined with immunohistochemical method, and the differences were statistically significant(P < 0. 05). In malignant tissues, three methods showed that the positive rates of TTF-1, CK7 and CEA were all high, and there were the highest ones in lung cancer,endometrial carcinoma and breast cancer, respectively. Conclusion Cell block preparation combined with immunohistochemistry is an effective method to identify benign and malignant effusion of serous cavity. The combination of TTF-1,CK7 and CEA has high application value.
Objective To explore the value of cell block combined immunohistochemistry in the diagnosis of serous cavity effusion. Methods 126 cases of hydro thorax and ascites were collected in our hospital from February 2010 to November 2017. In each case, common smear and liquid based cytology smear were performed simultaneously, and paraffin embedded, sliced and immunocytochemical staining was carried out in parallel centrifuge sediments. Results Compared with cell block preparation combined with immunohistochemistry, the positive rate of combined smear, immunohistochemistry and liquid based cytology smear combined with immunohistochemistry showed a significant difference, which was statistically significant(P <0.05). The uncertainty rate of smear combined with immunohistochemistry,liquid based cytology smear and immunohistochemistry was 34. 1 % and 23. 8%,respectively, which were both higher than those of cell block combined with immunohistochemistry(13.5%), and the differences were statistically significant( P <0.05). The false positive rate of cell block production combined with immunohistochemical method was lower than that of the common smear combined with immunohistochemical method and cell block production combined with the false negative rate was lower than that of the ordinary smear combined with immunohistochemical method and liquid based cytology combined with immunohistochemical method, and the differences were statistically significant(P < 0. 05). In malignant tissues, three methods showed that the positive rates of TTF-1, CK7 and CEA were all high, and there were the highest ones in lung cancer,endometrial carcinoma and breast cancer, respectively. Conclusion Cell block preparation combined with immunohistochemistry is an effective method to identify benign and malignant effusion of serous cavity. The combination of TTF-1,CK7 and CEA has high application value.
引文
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[9]马亮,赵滢,鲍晨辉,等.S100钙结合蛋白A6在胃癌组织中表达的意义[J].临床军医杂志,2016,44(4):423-426.
[10]张富娟,陈铁,张敬东.癌胚抗原、糖抗原199、C反应蛋白及白细胞介素-6对结直肠癌转移预测价值研究[J].临床军医杂志,2017,45(10):1014-1017.
[11]余何,李镭,刘丹,等.TTF-1、NapsinA、P63和CK5/6在肺癌组织的表达与分型诊断的价值[J].四川大学学报(医学版),2017,48(3):336-341.
[12]郭春红,成科,唐源,等.结直肠癌卵巢转移组织中CDX-2与CK7和CK20的表达及其临床意义[J].肿瘤预防与治疗,2016,29(6):310-314.
[2]高华玲,尹德娥,杜杰,等.TCT和HR-HPV-DNA检测在宫颈癌和癌前病变筛查中的临床价值[J].标记免疫分析与临床,2017.24(10):1115-1118.
[3]冯阳春,张园,刘诚明,等.鳞状上皮细胞癌抗原在高危型HPV感染人群宫颈病变分流诊治中的应用[J].东南大学学报(医学版),2016,35(6):989-992.
[4]寇露露,刘海霞,邵妤,等.加减血癥汤对人胃癌细胞SGC-7901增殖、凋亡及周期的影响[J].四川中医,2017,35(5):62-66.
[5]崔淼,许春伟,吴永芳,等.黏液炎性纤维母细胞肉瘤临床病理分析合并文献复习[J].实用癌症杂志,2016,31(2):310-312.
[6]张堃,韩志峰,赵英浩.非小细胞肺癌中TTF-1、Napsin A及CK7的表达及其意义[J].标记免疫分析与临床,2017,24(8):850-851,904.
[7]黄韬,伊丹丹,桑剑锋.乳腺浸润性微乳头状癌的免疫组化及预后分析[J].东南大学学报(医学版),2016,35(5):805-808.
[8]余燕琪.胸腔积液病理诊断中应用细胞块切片免疫组化染色检测的价值[J].医疗装备,2017,30(24):68-69.
[9]马亮,赵滢,鲍晨辉,等.S100钙结合蛋白A6在胃癌组织中表达的意义[J].临床军医杂志,2016,44(4):423-426.
[10]张富娟,陈铁,张敬东.癌胚抗原、糖抗原199、C反应蛋白及白细胞介素-6对结直肠癌转移预测价值研究[J].临床军医杂志,2017,45(10):1014-1017.
[11]余何,李镭,刘丹,等.TTF-1、NapsinA、P63和CK5/6在肺癌组织的表达与分型诊断的价值[J].四川大学学报(医学版),2017,48(3):336-341.
[12]郭春红,成科,唐源,等.结直肠癌卵巢转移组织中CDX-2与CK7和CK20的表达及其临床意义[J].肿瘤预防与治疗,2016,29(6):310-314.