免疫组化在肺小活检中对肺癌组织学分型的鉴别诊断意义

The differential diagnosis value of immunohistochemistry in lung biopsy

目的:探讨应用免疫组织化学标记在肺小活检中提高肺癌组织学分型的鉴别诊断意义。方法:收集三家医院小活检肺癌128例,免疫组化根据形态学观察情况选用抗体包括p63、p40、CK5/6、TTF-1、NapsinA、CK7、CgA、Syn、CD56、Ki-67等标记,通过单纯形态学观察和结合免疫组化分别进行肺癌组织学分型。结果:128例肺癌中单凭形态学观察肺癌分型准确率为77.34%,结合免疫组化分型准确率为91.41%,提高了14.07%。结论:肺癌小活检标本行免疫组化检测能提高肺癌组织学分型。建议在形态学基础上综合运用一组抗体:鉴别腺癌与鳞癌时选用TTF-1、NapsinA、CK7、p40、p63、CK5/6;倾向小细胞癌时选用CgA、Syn、CD56、Ki-67、TTF-1、p40。

Objective： To investigate the differential diagnostic value of immunohistochemical markers in lung biopsy to improve the histological type of lung cancer. Methods： A total of 128 patients with small lung cancer were collected from three hospitals,according to the morphological observation,immunohistochemical staining was performed with antibodies and reagents including p63,p40,CK5/6,TTF-1,NapsinA,CK7,CgA,Syn,CD56,Ki-67 and so on.The histological type of lung cancer was observed by morphological observation and morphological observation combined with immunohistochemistry respectively. Results： In 128 cases,the accuracy rate of lung cancer classification was only 77.34%,The accuracy of typing was 91.41% in combination with immunohistochemistry,which increased 14.07%. Conclusion： Immunohistochemical staining of lung cancer with small biopsy specimens improves the histological classification of lung cancer.We propose to use a set of antibodies based on morphology,differentiation of adenocarcinoma and squamous cell carcinoma using TTF-1,NapsinA,CK7,p40,p63,CK5/6.Consider small cell carcinoma using CgA,Syn,CD56,Ki-67,TTF-1,p40.