原发部位不明转移癌免疫组化检测及临床病理

The clinical pathologic retrospect and immunohistochemical determination of metastases of unknown origin in elderly

目的 对 41例老年原发部位不明的转移癌 (metastasesofunknownorigin ,MUO)进行原发灶的探讨 ,并分析可能提示原发部位的免疫组织化学及病理形态特征。 方法 以多项指标结合的 5组免疫酶标谱为主 ,配合大样本对照。检测前后分别进行临床及病理的前瞻性原发灶初诊及回顾性复诊。 结果 41例老年MUO给出意向诊断 31例 (75 6 % ) ,其中明确原发部位的 11例 (35 5 % ) ;并对原发灶的明确有提示意义的病理形态特征进行了详细的分析。 结论 免疫酶谱多指标分析对老年MUO原发灶鉴别诊断有实用价值 ,但须对其生物学行为 ,转移灶病理形态特征及临床各种检查进行综合分析 。

Objective To investigate the primary origin sites in 41 elderly patients with metastasis of unknown origin and analyse the immunohistochemical and pathological characteristics which perhaps can suggest the primary sites. Methods 5 groups of immunoenzyme spectrum with multi markes were detected mainly and contrasted with a great numbes of samples.The prespective and retrospective diagnosis of primary site in clinic and pathology was made respectively before and after the immunoenzyme spectrum was detected. Results Among these cases with MUO in elderly,the impressive diagnosis was considered in 31(75 6%)cases and the origin sites were diagnosed definitely in 11(35 5%)cases that were double of common methods.Also we analysed in detail the characteristics on pathologic morphology of MUO in elderly that had the significance on suggesting the origin sites. Conclusions Although there are practical significances for us to investigate the origin sites of MUO in elderly,a synthetic analysis in biologic functions and expressions on pathologic morphology and various clinical examinations should be performed for a further objective inspection.