液基细胞学及细胞蜡块联合免疫细胞化学检测在胸腹水细胞病理诊断中的临床价值
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摘要
目的探讨液基细胞学、细胞蜡块联合免疫细胞化学检测在胸腹水细胞病理学诊断中的临床价值。方法收集114例胸腹水标本,比较液基细胞学和细胞蜡块联合免疫细胞化学两种方法的阳性检出率,对可疑阳性和阳性的病例做免疫细胞化学检测,进一步判断细胞的良恶性及组织来源。结果 114例胸腹水标本中,液基细胞学诊断阳性36例(31.58%),细胞蜡块联合免疫细胞化学诊断阳性55例(48.24%),差异有统计学意义(P<0.01)。55例恶性胸腹水,胸水45例,腹水10例;胸水中肺腺癌32例,小细胞肺癌3例,乳腺癌4例,子宫内膜癌1例,淋巴造血系统肿瘤1例,来源不明4例;腹水中卵巢癌2例,消化系统肿瘤1例,子宫内膜癌1例,淋巴造血系统肿瘤1例,来源不明5例。结论细胞蜡块联合免疫细胞化学可以明显提高胸腹水阳性检出率,并帮助判断组织来源。
Objective To investigate the clinical value of liquid-based cytology and cell paraffin blocks combined with immunocytochemical examination in cytopathologic diagnosis of hydrothorax and ascites.Methods One hundred and fourteen cases of hydrothorax and ascites sample were collected.The detection positive rates were compared between the liquid-based cytology and cell paraffin blocks combined with immunocyochemical examination.The suspected positive and positive cases were performed the immunocytochemical examination for further judging benign and malignancy and histological source.Results 114 cases of hydrothorax and ascites samples,36 cases(31.58%)of positive were diagnosed by liquid-based cytologyamong and 55 cases(48.24%)of positive were diagnosed by cell paraffin blocks combined with immunocytochemical examination,the difference was statistically significant(P<0.01).There were 55 cases of malignant hydrothorax and ascites,45 cases were hydrothorax and 10 cases were ascites,in hydrothorax,there were 32 cases of lung adenocarcinoma,3 cases of small cell lung cancer,4 cases of breast cancer,1 case of endometrial carcinoma,1 case of lymphatic hematopoietic system tumor and 4 cases of unknown origin;in ascites,there were 2 cases of ovarian cancer,1 case of digestive system tumor,1 case of endometrial cancer,1 case of lymphatic hematopoietic system tumor and 5 cases of unknown origin.Conclusion The cell paraffin blocks combined with immunocytochemistry can significantly improve the positive detection rate of hydrothorax and ascites,and helps to judge the source of tissue.
Objective To investigate the clinical value of liquid-based cytology and cell paraffin blocks combined with immunocytochemical examination in cytopathologic diagnosis of hydrothorax and ascites.Methods One hundred and fourteen cases of hydrothorax and ascites sample were collected.The detection positive rates were compared between the liquid-based cytology and cell paraffin blocks combined with immunocyochemical examination.The suspected positive and positive cases were performed the immunocytochemical examination for further judging benign and malignancy and histological source.Results 114 cases of hydrothorax and ascites samples,36 cases(31.58%)of positive were diagnosed by liquid-based cytologyamong and 55 cases(48.24%)of positive were diagnosed by cell paraffin blocks combined with immunocytochemical examination,the difference was statistically significant(P<0.01).There were 55 cases of malignant hydrothorax and ascites,45 cases were hydrothorax and 10 cases were ascites,in hydrothorax,there were 32 cases of lung adenocarcinoma,3 cases of small cell lung cancer,4 cases of breast cancer,1 case of endometrial carcinoma,1 case of lymphatic hematopoietic system tumor and 4 cases of unknown origin;in ascites,there were 2 cases of ovarian cancer,1 case of digestive system tumor,1 case of endometrial cancer,1 case of lymphatic hematopoietic system tumor and 5 cases of unknown origin.Conclusion The cell paraffin blocks combined with immunocytochemistry can significantly improve the positive detection rate of hydrothorax and ascites,and helps to judge the source of tissue.
引文
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[12]徐小艳,刘红伟,姜黄,等.联合检测细胞蜡块中的napsinA和甲状腺转录因子-1有助于肺腺癌胸水的诊断[J].南方医科大学学报,2015,35(11):1610-1613.
[13]张丽华,王雪晴,王国庆,等.细胞蜡块在晚期腺癌诊断和肺腺癌个体化治疗中的应用价值[J].临床与实验病理学杂志,2014,30(2):166-170.
[14]候兴华,金素芬,李春杨,等.组合型抗体在胸腔积液细胞块诊断中的应用[J].诊断病理学杂志,2014,21(8):510-512.
[15]毛渭东,贺丹丹,何洪伟,等.免疫组化标记在恶性浆膜腔积液中的应用价值探讨[J].诊断病理学杂志,2015,22(10):634-636.
[16]黄智勇,苏海燕,林燕玲,等.细胞块联合免疫组化染色在恶性浆膜腔积液诊断中的应用[J].齐齐哈尔医学院学报,2016,37(23):2873-2875.
[17]尹迎春,王新美,李良,等.非小细胞肺癌胸腔积液细胞蜡块检测EGFR与K-ras基因突变EML4-ALK融合基因及其临床病理特征[J].中国胸心血管外科临床杂志,2015,22(9):870-874.
[2]丁春晓,张洋,张恒,等.联合抗体免疫组织化学检测胸水细胞对恶性间皮瘤诊断的应用价值分析[J].中国组织化学与细胞化学杂志,2016,25(2):163-168.
[3]MINATO H,KUROSE N,FUKUSHIMA M,et al.Comparative immunohistochemical analysis of IMP3,GLUTI,EMA,CD146,and desmin for distinguishing malignant mesothelioma from reactive mesothelial cells[J].Am J Clin Pathol,2014,141(1):85-93.
[4]CHANG S,OH M H,JI S Y,et al.Practical utility of insulin-like growth factorⅡmRNA-binding protein 3,glucose transporter 1,and epithelial membrane antigen for distinguishing malignant mesotheliomas from benign mesothelial proliferations[J].Pathol Int,2014,64(8):607-612.
[5]汪露祥,陈龙,吴献忠,等.GLUT1和Claudin-4在胸水转移性肺腺癌细胞及反应性增生间皮细胞中的表达[J].皖南医学院学报,2015,34(6):538-541.
[6]BENZERDJEB N,BERNA P,SEVESTRE H.GLUT1:A novel tool reflecting proliferative activity of lung neuroendocrine tumors[J].Pathol Int,2017,67(1):32-36.
[7]YOUNG W K,SU J L,SEONG Y P.Differential expression and prognostic significance of GLUT1according to histologic type of non-small-cell lung cancer and its Association with volume-dependent parameters[J].Lung Cancer,2017,104(1):31-37.
[8]杨新,王秋实,李艳青,等.细胞蜡块结合免疫组化有效提高胸水细胞学阳性检出率的临床研究[J].现代肿瘤医学,2014,22(12):2894-2897.
[9]王文军,张伟,陈玉娟,等.细胞蜡块免疫标记在浆膜腔积液腺癌细胞病理诊断中的临床价值[J].山西医科大学学报,2014,45(4):288-290.
[10]宋新兰,付娟娟.恶性胸腹水液基细胞学及免疫组化检查的临床病理分析[J].新疆医学,2015,45(9):1247-1250.
[11]罗丽花,张婉仪,刘惠娟,等.细胞蜡块联合免疫组化在胸腔积液诊断中的应用[J].临床与实验病理学杂志,2015,31(8):904-907.
[12]徐小艳,刘红伟,姜黄,等.联合检测细胞蜡块中的napsinA和甲状腺转录因子-1有助于肺腺癌胸水的诊断[J].南方医科大学学报,2015,35(11):1610-1613.
[13]张丽华,王雪晴,王国庆,等.细胞蜡块在晚期腺癌诊断和肺腺癌个体化治疗中的应用价值[J].临床与实验病理学杂志,2014,30(2):166-170.
[14]候兴华,金素芬,李春杨,等.组合型抗体在胸腔积液细胞块诊断中的应用[J].诊断病理学杂志,2014,21(8):510-512.
[15]毛渭东,贺丹丹,何洪伟,等.免疫组化标记在恶性浆膜腔积液中的应用价值探讨[J].诊断病理学杂志,2015,22(10):634-636.
[16]黄智勇,苏海燕,林燕玲,等.细胞块联合免疫组化染色在恶性浆膜腔积液诊断中的应用[J].齐齐哈尔医学院学报,2016,37(23):2873-2875.
[17]尹迎春,王新美,李良,等.非小细胞肺癌胸腔积液细胞蜡块检测EGFR与K-ras基因突变EML4-ALK融合基因及其临床病理特征[J].中国胸心血管外科临床杂志,2015,22(9):870-874.