一组细胞角蛋白抗体在胸腹腔积液中的表达及其鉴别诊断价值

A Panel of Cytokeratin Antibodies Expression and its Value of Differential Diagnosis in Pleural and Peritoneal Effusion

目的:探讨一组细胞角蛋白抗体在胸腹腔积液中的表达情况及其临床应用价值。方法:选取72例胸腹腔积液标本,其中腺癌30例,鳞癌22例,反应增生性间皮细胞22例,应用细胞免疫化学SP法检测细胞角蛋白CK(AE1/AE3)、细胞角蛋白5/6(CK5/6)、细胞角蛋白18(CK18)的表达。结果:三种抗体在反应增生性间皮细胞、腺癌细胞、鳞癌细胞中阳性率分别是CK(AE1/AK3):10.0%,73.3%,68.2%;CK5/6:60.0%,6.7%,77.3%;CK18:0,80.0%,4.5%。组合CK(AE1/AE3)(-)、CK5/6(+)、CK18(-)检测间皮细胞的敏感性为93.3%,特异性为80.2%;CK5/6(-)、CK18(+)检测腺癌细胞的敏感性为84.7%,特异性为93.6%;CK(AE1/AE3)(+)、CK5/6(+)、CK18(一)检测鳞癌细胞的敏感性为86.4%,特异性为92.8%。结论:多项细胞角蛋白联检提高了诊断反应增生性间皮细胞、腺癌细胞、鳞癌细胞的敏感性和特异性,可辅助细胞形态学对于良恶性胸腹腔积液的鉴别诊断。

Objective To study the expressive and applicative value of a panel of cytokeratin antibodies in pleural and peritoneal effusion. Methods SP immunocytoehemisitry technique was used to detect the expression of CK, CK5/6, CKI8 in seventy-two cases pleural and peritoneal effusion samples ,30 cases of adenocarcinoma ,22 cases of squamous carcinoma and 20 cases of reactive proliferation mesothelial cells. Results Expression positivity rates of three antibodies in mesothelial, adeno and squamous carcinoma cells were CK （ AE/AE3 ） ： 10.0% ,73.3 %, 68.2% ; CK5/6 ： 60.0%, 6.7 % ,77.3 % ; CK18 ： 0,80.0% ,4.5 % respectively , CK （ AE1/ AE3） （ - ） ;CK5/6（ ＋ ） ,CK18（ - ） identified mesothelial cell with 93.3% sensitivity and 80.2% specificity ; CK5/6（ - ）, CK18 （ ＋ ）identified adenocarcinoma cell with 84.7% sensitivity and 93.6% specificity; CK （AE1/AE3） （ ＋ ）, CK5/6 （ ＋ ）, CK18 （ - ） identified squamous cell carcinomas with 86.4% sensitivity and 92.8% specificity. Conclusion The eoexpression of muhinomial eytokeratin improve the sensitivity and speciality of mesothelial, adeno and squamous carcinoma cells , and assist cytomorphology in differential diagnosis between benign and pleural and malignant peritoneal effusion .