免疫磁珠阴性富集法在恶性胸腔积液细胞块制作中的应用

Application of immunomagnetic beads negative enrichment in the production of malignant pleural effusion cell mass

目的:探讨应用免疫磁珠阴性富集法制作恶性胸腔积液细胞块的可行性及其应用价值。方法:收集确诊为肺腺癌的胸腔积液57例,每例标本平均分成两份,分别用传统直接离心沉淀法(A法)和免疫磁珠阴性富集法(B法)制作细胞块,对两种方法获得的细胞块的HE染色、免疫组化效果及提取DNA的合格率、EGFR基因突变检测结果进行比较。结果:免疫磁珠阴性富集法的HE、免疫组化效果均优于传统的直接离心沉淀法;直接离心沉淀法提取的DNA浓度普遍高于免疫磁珠阴性富集法;直接离心沉淀法和免疫磁珠阴性富集法提取DNA的合格率分别为96.61%(57/59)和98.31%(58/59),两者差异无统计学意义(P>0.05);免疫磁珠阴性富集法EGFR基因突变阳性率为59.32%(35/59),高于直接离心沉淀法的54.24%(32/59),两者差异无统计学意义(P>0.05)。结论:应用免疫磁珠阴性富集法制作恶性胸腔积液细胞块的方法可行,在HE染色、免疫组化以及后续的分子病理检测与传统的直接离心沉淀法相比较均显示出较大的优势。

Objective:To explore the feasibility and application value of immunomagnetic bead negative enrichment method for malignant pleural effusion cell mass.Methods:57 cases of pleural effusion diagnosed as lung adenocarcinoma were collected and divided into two parts on average.Cell blocks were made by traditional direct centrifugal precipitation method(A method) and immunomagnetic bead negative enrichment method(B method).HE staining, immunohistochemical effect,DNA extraction eligibility rate and EGFR gene mutation detection results of cell blocks obtained by the two methods were compared.Results:HE and immunohistochemical effects of immunomagnetic bead negative enrichment method were better than those of traditional direct centrifugal precipitation method.DNA concentration extracted by direct centrifugal precipitation method was generally higher than that by immunomagnetic bead negative enrichment method.The qualified rates of DNA extracted by direct centrifugal precipitation method and immunomagnetic bead negative enrichment method were 96.61%(57/59) and 98.31%(58/59),respectively,with no significant difference(P>0.05).The positive rate of EGFR gene mutation by immunomagnetic bead negative enrichment method was 59.32%(35/59),which was higher than that by direct centrifugal precipitation method 54.24%(32/59),respectively,with no significant difference(P>0.05).Conclusion:It is feasible to use immunomagnetic bead negative enrichment method to make malignant,pleural effusion cell blocks.Compared with the traditional direct centrifugal precipitation method,HE staining,immunohistochemistry and subsequent molecular pathological detection show greater advantages.