免疫组化在肺小细胞癌和肺非小细胞癌活检标本中的鉴别诊断价值

Application of immunohistochemistry in biopsy specimen for differential diagnosis of small cell lung carcinoma and non-small cell lung carcinoma

目的：探讨免疫组化在肺小细胞癌（SCLC）和肺非小细胞癌（NSCLC）鉴别诊断中的作用。方法应用免疫组化SP法，选择肺穿刺及支气管镜活检标本，病理形态疑似SCLC 共72例，检测CD56、Syn、TTF1、CK5/6、CK14、P63、CK7及NapsinA的蛋白表达，分析SCLC的病理形态特征和免疫表型特点及其与NSCLC的鉴别。结果72例肺癌患者中，SCLC共27例，低分化鳞状细胞癌（SCC）共17例，低分化腺癌（ADC）共28例。结论 SCLC和NSCLC在临床治疗上方法不同，充分应用免疫组化可以进行诊断和鉴别诊断，从而可以减少误诊，同时给临床治疗方案的选择提供重要依据。

Objective To investigate the role of immunohistochemistry in the differential diagnosis between small cell lung carcinoma （SCLC） and non-small cell lung carcinoma （NSCLC）.Methods The protein expressions of CD56, Syn, TTF1, CK5/6, CK14, P63, CK7, and NapsinA in percutaneous lung biopsy and bronchoscopic biopsy specimens which were suspected as SCLC were examined by immunohistological streptavidin-peroxidase （ SP） method to analyze the pathological characteristics , immunological pheno-typical features , and differential diagnosis between SCLC and NSCLC .Results Among 72 cases of lung cancer patients ,there were 27 cases of SCLC,17 cases of low differentiated squamous cell carcinoma （ SCC） and 28 cases of low differentiated adenocarcinoma （ ADC） .Conclusions It is the different therapy between SCLC and NSCLC , immunohistochemistry analysis of biopsy can provide ac-curate diagnosis of SCLC and NSCLC , which will result in less misdiagnosis and provide an important valuable in the selection of clini -cal treatment protocols for lung cancer patients .