恶性胸膜间皮瘤与肺腺癌的免疫学鉴别诊断

Application of Immunohistochemistry in Distinction between Malignant Pleural Mesothelioma and Pulmonary Adenocarcinoma

目的探讨免疫组化指标calretinin、vimentin、CK5/6、AE1/AE3、EMA、CEA在恶性胸膜间皮瘤与肺腺癌鉴别诊断中的作用。方法采用免疫组化LSAB法检测13例恶性胸膜间皮瘤和25例肺腺癌中calretinin、vimentin、CK5/6、AE1/AE3、EMA、CEA的表达情况。结果 calretinin、EMA、CEA、vimentin在恶性胸膜间皮瘤和肺腺癌中的表达差异有统计学意义(P<0.05),间皮瘤最敏感的抗体是vimentin和AE1/AE3,而特异性最高的抗体是calretinin。在肺腺癌中,敏感性最高的抗体是AE1/AE3,其次是EMA、CEA,特异性最高的抗体是CEA。结论 calretinin、vimentin、CEA一组抗体兼具特异性和敏感性,可作为恶性间皮瘤和肺腺癌鉴别诊断中的首选抗体。

Objective To investigate the value of testing ealretinin, vimentin, CK5/6, AE1/AE3, EMA and CEA in the differential diagnosis between malignant pleural mesothelioma and pulmonary adenoeareinoma. Methods The expression of the above biomarkers was deteeted by immunoehemieal LSAB method in 13 eases of malignant pleura] mesothelioma and 25 eases of pulmonary adenoeareinoma. Results There was a significant difference in expression of ealretinin, EMA, CEA and vimentin between malignant pleuralmesothelioma and pulmonary adenoeareinoma（P 〈 0.05 ） , the most sensitive antibody to malignant pleural mesothelioma was vimentin and AEI/AE3 ;The most specific antibody to malignant pleural mesothelioma was ealretinin;the most sensitive antibody to pulmonary adenoeareinoma was AE1/AE3, followed by EMA and CEA;the most specific antibody to pulmonary adenoeareinoma was CEA. Conclusion A panel of antibodies including Calretinin, vimentin and CEA with a high combined sen- sitivity and specificity can be used as primary antibodies for distinguishing malignant pleural mesothelioma from pulmonary adenocarcinoma.