TP免疫细胞化学对浆膜腔积液腺癌细胞及反应性间皮细胞的鉴别诊断

ThinPrep Immunocytochemical Stain in the Differential Diagnosis between Adenocarcinoma and Reactive Mesothelial Cells in Body Cavity Fluid

目的探讨薄层细胞涂片法(TP)免疫细胞化学对浆膜腔积液中腺癌细胞及反应性间皮细胞鉴别诊断的应用价值。方法对65例浆膜腔积液行常规HE染色,其中包括胸腔积液26例,腹水33例和心包积液6例。全部采用TP免疫细胞化学检测癌胚抗原(CEA)、上皮抗原(EA)、间皮细胞抗原(MC)和钙结合蛋白(Ca1)抗原的表达。结果42例腺癌中90.5%(38/42)CEA表达阳性,95.2%(40/42)EA表达阳性,4.8%(2/42)MC表达阳性,4.8%(2/42)Cal表达阳性。在23例反应性间皮细胞中,反应性间皮细胞CEA和EA全部呈阴性表达,91.3%(21/23)MC表达阳性,87.0%(20/23)Cal表达阳性。CEA和EA在腺癌细胞中特异性为100.0%。MC和Cal在良性反应性间皮细胞中特异性为95.2%。结论通过TP免疫细胞化学方法,选择性的联合使用4种抗体(CEA、EA、MC、Cal)可以帮助对浆膜腔积液中腺癌细胞与反应性间皮细胞的鉴别诊断。

Objective To elucidate the value of ThinPrep immunocytochemical stain in the differential diagnosis between adenocarcinoma and reactive mesothelial cells in body cavity fluid.Methods HE and ThinPrep immunocytochemical stain were applied to 65 cytological specimens,including pleural（26 specimens）,peritoneal（33 specimens）,and pericardial（6 specimens） fluids.The expression of carcinoembryonic antigen（CEA）,Epithelial antigen（EA）,Mesothgelial Cell antigen（MC）,and Calretinin antigen（Cal） were analyzed by ThinPrep immunocytochemical stain.Results In adenocarcinoma,CEA expression was positive in 90.5%（38/42）,EA expression was positive in 95.2%（40/42）,MC was positive in 4.8%（2/42） Cal was positive in 4.8%（2/42）.In reactive mesothelial cells,the expression of CEA,EA,MC and Cal was 0,0,91.3%（21/23） and 87.0%（20/23）.The specificity of CEA and EA for adenocarcinomas was 100% and the specificity of MC and Cal for reactive mesothelial cells was 95.2%.Conclusion Combined analysis of CEA,EA,MC,and Cal by ThinPrep immunocytochemical stain would be helpful in the differential diagnosis between adenocarcinoma and reactive mesothelial cells.