联合检测ER、Vimentin、CK8/18、CEA对子宫内膜腺癌和宫颈腺癌鉴别诊断的意义

The Combined Assays of Tumor Marker Vimentin, ER,CK8/CK18 and CEA for Differential Diagnosis of Primary Endometrial and Cervical Adenocarcinomas

目的:探讨肿瘤标志物联合检测对于鉴别子宫内膜腺癌和宫颈腺癌的意义。方法:收集手术标本的石蜡切片61例,其中原发性子宫内膜腺癌35例,宫颈腺癌26例。用免疫组化法检测子宫内膜腺癌和宫颈腺癌中Vim entin,ER,CK8/18,CEA的阳性率。结果:子宫内膜腺癌Vim entin,ER,CK8/18,CEA的阳性率分别为74.3%,54.3%,91.4%,40.0%,宫颈腺癌的阳性率分别为11.5%,11.5%,50.0%,92.3%,子宫内膜腺癌Vim entin,ER,CK8/18的阳性率明显高于宫颈腺癌(P<0.005),而宫颈腺癌CEA的阳性率明显高于子宫内膜腺癌(P<0.005)。联合检测结果发现,Vim entin+ER+CK8/18+CEA四项联合与Vim entin+CK8/18+CEA三项联合的诊断符合率相同(总符合率为93.4%,子宫内膜腺癌91.4%,宫颈腺癌96.2%),均高于Vim entin+ER+CEA的诊断符合率(总符合率为86.9%,子宫内膜腺癌85.7%,宫颈腺癌88.5%)。结论:肿瘤标志物CK8/18有助于临床上鉴别原发性子宫内膜腺癌和宫颈腺癌,联合检测中以Vim entin+ER+CK8/18+CEA或Vim entin+CK8/CK18+CEA为佳。

Objective: To study the clinical significance of tumor markers combined assay in the differential diagnosis of primary endometrial and cervical adenocarcinomas. Methods: A tissue microarray was constructed using paraffin-embeded, formalin-fixed tissues from 61 hysterectomy specimens. Among them, 35 cases were endometrial adenocarcinomas, 26 cases were cervical adenocarcinomas.Tissue array sections were immunostained with four commercially available antibodies(vimentin, ER, CK8/CK18, CEA) utilizing the avidin-biotin(ABC) tichnique. Positive rate was count respectively. Results: Positive rates of vimentin, ER, CK8/CK18, CEA in endometrial adenocarcinomas were 74.3%, 54.3%, 91.4% and 40.0%, respectively; the positive rates in cervical adenocarcinomas were 11.5%,11.5%, 50.0% and 92.3%, respectively. The positive rates of vimentin, ER, CK8/CK18 in endometrial adenocarcinomas were higher significantly than those in cervical adenocarcinomas (P<0.005), the positive rate of CEA in endometrial adenocarcinomas was lower significantly than that in cervical adenocarcinomas (P<0.005). When combined together, the diagnostic consistency of combined assays with vimentin+ER+CK8/ CK18+CEA was the same as the combined assays with vimentin+ CK8/CK18+CEA (the total was 93.4%, endometrial adenocarcinomas was 91.4%, cervical adenocarcinomas was 96.2%). Both were higher than that of combined assays with vimentin+ER+CEA (the total was 86.9%, endometrial adenocarcinomas was 85.7%, cervical adenocarcinomas was 88.5%). Conclusion: Tumor marker of CK8/CK18 has significantly clinical value in the differential diagnosis of primary endometrial and cervical adenocarcinomas. The combined assays with vimentin+ER+ CK8/CK18+CEA and vimentin+CK8/CK18+CEA were recommended.