免疫细胞化学与浆膜腔积液细胞学诊断

The Value of Immunocytochemistry in the Cytological Diagnosis of Serous Effusion

目的解决浆膜腔积液中疑难病例的确诊、分型,探讨免疫细胞化学在积液中鉴别诊断的价值,找出适于这项诊断的最佳抗体。方法选用6种单克隆抗体[上皮细胞膜抗原(EM A)、癌胚抗原(CEA)、钙视网膜素(CAL)、细胞角蛋白(CK 17)、细胞角蛋白(CK 18)、波形蛋白(v im en tin)]对58例积液标本进行诊断。结果在58例积液中,免疫细胞化学鉴别出恶性积液38例,反应性积液20例。结论CAL、EM A、CEA、v im en tin联合应用可从正反两个方面同时证明癌细胞的存在,是积液中免疫细胞化学的最佳抗体组合。CK 17、CK 18对鉴别积液中鳞癌、腺癌有参考价值。在细胞学检查中应普遍推广免疫细胞化学。

Objective To investigate the value of immunocytochemistry （ICC） in the differential diagnosis of difficult cases with serous effusion in the serous cavity. Methods The immunocytoehemical method was utilized for the differential diagnosis and classification of malignant tumor cells in serous effusion. EMA,CEA,CAL,CK17,CK18 and vimentin were selected in the study of 58 cases of serous specimen. Results In eases with immunocytochemical examlnations,there were 38 cases malignant and 20 eases reactive. Conclusions CAL, EMA, CEA, vimentin used in combination are the best antihody＇s composition for the identification of cancer cells from both negative and positive sides. CK17 and CK18 have some reference value in the differentiation of squamous cell carcinoma from adenocarcinoma in the effusion. Therefore,immunocytochemistry should be widely used in cytoloyical diagnosis.