弹性纤维染色在评估肺癌胸膜侵犯中的应用价值

Application significance of elastic fiber staining in the assessment of lung cancer pleural invasion

目的利用维多利亚蓝染色法(EVG)对肺癌组织中弹性纤维进行定位,判断肿瘤和胸膜的关系,根据肿瘤旁弹性纤维性状,确定胸膜被侵犯程度,对肿瘤进行分期。方法选用术后病理证实为肺癌,HE染色后不能明确是否侵犯胸膜的病例,进行弹性纤维染色。结果经弹性纤维染色后,可更清晰显示出弹性纤维的分布性状以及与胸膜的关系,特别是肿块紧靠胸膜的病例,区分HE染色难以判断的病例,能准确判断肿瘤是否达到胸膜或侵犯胸膜程度。结论与HE染色相比,弹性纤维染色可清晰显示弹性纤维的分布状况,更直观判断出肿瘤与胸膜关系,定位定性更准确,有助于评估肿瘤侵袭程度及患者的临床预后。

Objective To localize elastic fibers by using Elastic Tissue Fibers-Verhoeff’s Van Gieson(EVG)staining method with Victorian blue in lung cancer tissues,so as to determine the relationship between the tumor and the pleura,and thus to determine the extent of pleural invasion and stage the tumor according to the para-tumor elastic fiber traits.Methods Lung cancer cases confirmed by postoperative pathology,and unable to determine whether the pleura was invaded by HE staining,were seletected and treated by elastic fibers staining.Results After elastic fibers staining,the distribution of elastic fibers and their relationship to the pleura were clearer,especially in cases where the mass was close to the pleura,which contributed to distinguishing the cases with difficulty in evaluation by HE staining from others and accurately determining whether the tumor has invaded the pleura or invasion degree.Conclusion Compared with HE staining,EVG staining shows clearer distribution of elastic fibers,which leads to more direct determination of the relationship between tumor and pleura with more accurate positioning,and therefore helps assess tumor invasion and clinical prognosis.