胸腹水细胞学与组织学制片的免疫细胞化学诊断对比研究

Contrasting study of immunocytochemical diagnosis between cytology and histopathology of pleural and peritoneal effusion

目的探讨脱落细胞学与组织病理学制片在胸腹水恶性细胞诊断中的敏感性。方法103例患者胸腹水标本经特殊处理后,分别做细胞学涂片和石蜡包埋制片,并采用免疫细胞化学(ICC)方法,用肿瘤相关糖蛋白72和癌胚抗原组合、神经特异性钙结合蛋白和血栓素组合进行诊断,比较其阳性检出率。结果石蜡包埋制片肿瘤相关糖蛋白72和癌胚抗原组合、神经特异性钙结合蛋白和血栓素组合分别诊断转移腺癌阳性率97.9%、恶性间皮瘤阳性率100%;应用相应抗体组合,细胞学涂片的阳性率分别为95.8%,100%。两者阳性率比较无显著性差异(x2=0.17,P>0.05)。结论通过对胸、腹水标本和材料的前期有效处理后,细胞学涂片的免疫细胞化学诊断转移性腺癌、恶性间皮瘤的敏感性与组织学方法具有较高的一致性。

Objective To study the diagnostic sensitivity between exfoliative cytology and histopathology of pleural and peritoneal effusion. Methods 103 samples of pleural and peritoneal effusion were prepared by paraffin imbedding and cytological smear respectively. Malignant tumor cells were identified with the combinatorial antibodies of cancerrelated glycoprotein 72 and CEA, nerve-specificity calcium binding protein and thrombexan. Results The positive rate prepared by paraffin imbedding was 97.9% with cancerrelated glycoprotein 72 and CEA, and with 100% of nerve-specificity calcium binding protein and thromboxan. The positive ratios prepared by cytological smear were 95.8% and 100% with the correspondence immunoeytochemistry above. There was no significantly different between the two methods（x^2=0.17,P〉0.05）. Conclusions The diagnostic sensitivity of cytological smear combined the antibodies, through handling the samples from pleural and peritoneal effusions, is of similarity comparing with that of paraffin imbedding.