免疫组化在恶性胸膜间皮瘤与肺腺癌鉴别诊断中的作用分析

Analysis of the Role of Immunohistochemistry in the Differential Diagnosis of Malignant Pleural Mesothelioma and Lung Adenocarcinoma

目的探讨免疫组化检查对于恶性胸膜间皮瘤与肺腺癌的诊断鉴别作用。方法收集恶性胸膜间皮瘤患者17例以及肺腺癌患者33例,采用免疫组化EnVision二步法进行检测,比较两种疾病患者的免疫组化检查结果。结果恶性胸膜间皮瘤的CD141、WT1、calretinin、EMA、CK5/6、B72.3、Ber-EP4、AE1/AE3、CEA的表达依次为82.4%、58.8%、58.8%、58.8%、64.7%、0.0%、5.9%、82.4%、0.0%,与肺腺癌的3.0%、9.1%、0.0%、97.0%、9.1%、72.7%、63.6%、100.0%、90.9%比较差异有统计学意义(P<0.05),两种病变间Moc-31与HBME-1表达差异无统计学意义(P>0.05)。结论免疫组化检查对于恶性胸膜间皮瘤与肺腺癌的诊断鉴别具有重要意义,以calretinin、CD141、WT-1、CEA与B72.3的敏感性与特异性最高。

Objective To investigate the role of immunohistochemical examination in the differential diagnosis of malignant pleural mesothelioma and lung adenocarcinoma. Methods 17 cases of patients with malignant pleural mesothelioma and 33 cases with lung adenocarcinoma were collected. Immunohistochemical EnVision two steps method was used for detection. And the immunohistochemical results of the two groups were compared. Results The expression of CD141, WT1, calretinin, EMA, CK5/6, B72.3, BerEP4, AE1/AE3, CEA in malignant pleural mesothelioma was 82.4%, 58.8%, 58.8%, 58.8%, 64.7%, 0.0%, 5.9%, 82.4%, 0.0%, respectively, and that in lung adenocarcinoma was 3.0%, 9.1%, 0.0%, 97.0%, 9.1%, 72.7%, 63.6%, 100.0%, 90.9%, respectively.There was significant difference between the two groups（P〈0.05）. The expression of Moc-31 and HBME-1 between the two groups had no significant difference（P〉0.05）. Conclusion Immunohistochemical examination plays an important role in the differential diagnosis of malignant pleural mesothelioma and lung adenocarcinoma, the sensitivity and specificity of calretinin, CD141, WT-1,CEA and B72.3 are the highest.