免疫组化在肺小结节穿刺活检标本中对非小细胞肺癌诊断应用分析

Analysis of the Application of Immunohistochemistry in the Diagnosis of Non-small Cell Lung Cancer in Small Pulmonary Nodule Biopsy Specimens

目的探讨CT引导下肺周围性小结节病变穿刺活检标本的免疫组化检测在非小细胞肺癌(NSCLC)鉴别诊断中的应用价值。方法方便收集该院2015年3月—2017年10月95例肺小结节穿刺活检所得组织学及细胞学标本,肿物平均直径3.0 cm,病理明确诊断非小细胞肺癌(NSCLC),采用免疫组化法对其结果进行回顾性分析,以充分了解TTF-1、Napsin A、P63、CK5/6、CK7表达情况,探讨其在非小细胞肺癌鉴别诊断中的应用价值,采用SPSS 19.0统计学软件进行统计学分析,计数资料采用率(%)进行统计学描述,检测技术计数资料之间比较采用χ2检验,以P<0.05为差异有统计学意义。结果 95例临床经皮肺穿刺活检标本中,60例肺腺癌患者,TTF-1、Napsin A、CK-7蛋白表达的阳性率依次为93.3%、95.0%、98.3%;明显高于肺鳞癌的2.8%、5.7%、37.1%;组间差异有统计学意义(χ2=75.4,74.88,45.11,P<0.01);35例肺鳞癌患者,P63、CK5/6蛋白表达的阳性率依次为91.4%、97.3%;明显高于肺腺癌的6.7%、8.3%,组间差异有统计学意义(χ2=67.48,72.05,P<0.01)。结论 CT引导下肺周围性小结节病变穿刺活检与手术切除活检相比,患者痛苦小,并发症少,对肺组织结构的破坏不明显,病理常规组织诊断学与免疫组织化学相结合,观察TTF-1、NapsinA、P63、CK5/6、CK7蛋白表达情况,为肺非小细胞肺癌鉴别诊断学提供了科学的诊断依据,对肺部周围性小结节诊断具有重的临床应用价值。

Objective To investigate the value of immunohistochemical detection of CT-guided small pulmonary nodules in biopsy specimens for differential diagnosis of non-small cell lung cancer (NSCLC). Methods Convenient collection of our hospital from March 2015 to October 2017 Histological and cytological specimens from 95 small pulmonary nodules biopsy, the average diameter of the tumor was 3.0 cm. The pathological diagnosis of non-small cell lung cancer (NSCLC) was per-formed. The results were retrospectively analyzed by immunohistochemistry. Fully understand the expression of TTF-1, NapsinA, P63, CK5/6, CK7, and explore its application value in the differential diagnosis of non-small cell lung cancer. Statistical analysis was performed using SPSS 19.0 statisticanl software, and the statistical data rate (%) was used for statis-tics. The description of the test and the comparison of the test technique count data were performed using the X^2 test, and the difference was statistically significant at P<0.05. Results In 95 cases of clinical percutaneous lung biopsy specimens, the positive rates of TTF-1, NapsinA, and CK-7 protein expression were 93.3%, 95.0%, and 98.3%, respectively, in 60 pa-tients with lung adenocarcinoma;2.8%, 5.7%, and 37.1% lung squamous cell carcinoma;the difference between the groups was statistically significant (X^2=75.4, 74.88, 45.11, P<0.01);the positive rate of P63 and CK5/6 protein expression in 35 pa-tients with lung squamous cell carcinoma order was 91.4% and 97.3%, which was significantly higher than 6.7% and 8.3% of lung adenocarcinoma. The difference between the groups was statistically significant (X^2=67.48, 72.05, P<0.01). Conclu-sion Compared with surgical biopsy, CT-guided small pulmonary nodule lesion biopsy has less pain, fewer complications, and less damage to lung tissue structure. Pathological routine tissue diagnosis combined with immunohistochemistry. The expression of TTF-1, NapsinA, P63, CK5/6 and CK7 protein was observed, which provided a scientific basis for the differ-ential diagnosis of lung non-small cell lung cancer. It has a clinical application value for the diagnosis of pulmonary small nodules.