CK7、CK20、Villin、MOC-31和Ber-Ep4对浆膜腔积液转移性腺癌的鉴别作用

Significance of CK7,CK20,Villin, MOC-31 and Ber-Ep4 in identifying metastatic adenocarcinoma in serous effusion

目的探讨细胞角蛋白7(CK7)、CK20、绒毛蛋白(Villin)、MOC-31和Ber-Ep4在浆膜腔积液中判断肿瘤性质及来源的价值。方法收集188例浆膜腔积液细胞蜡块;其中,腺癌91例,非肿瘤性积液97例。采用免疫细胞化学方法检测细胞蜡块切片中的CK7、CK20、Villin、MOC-31和Ber-Ep4的表达。结果 Villin、MOC-31和Ber-Ep4在腺癌与非肿瘤性浆膜腔积液中的阳性表达率差异均有统计学意义(P<0.05)。CK7、CK20、Villin、MOC-31和Ber-Ep4诊断腺癌的灵敏度分别为89.0%、28.6%、53.8%、98.9%和53.8%,特异度分别为4.3%、100%、95.7%、94.8%和100%。CK7+CK20+Villin以及CK7+CK20同时阳性表达均最常见于胃腺癌;CK7+Villin同时阳性表达最常见于胆管腺癌;CK20+Villin同时阳性表达最常见于结肠腺癌。结论 CK7、CK20、Villin、MOC-31和Ber-Ep4这组抗体不仅能有效鉴别浆膜腔积液中的腺癌,同时对判断肿瘤来源也具有较好的作用。

Objective To investigate the significance of cytokeratin 7(CK7),cytokeratin 20(CK20),Villin, MOC-31 and Ber-Ep4 in identifying the metastatic adenocarcinoma in serous effusion.Methods A total of 188 cell wax blocks of serous effusion were collected, which included 91 cases of adenocarcinoma(group A) and 97 cases of non-neoplastic effusion(group B).The expressions of CK7,CK20,Villin, MOC-31 and Ber-Ep4 in the cell wax blocks were detected by immunocytochemistry.ResultsThere were significant differences in the positive expression rates of Villin, MOC-31 and Ber-Ep4 between the two groups(P<0.05).The sensitivities of CK7,CK20,Villin, MOC-31 and Ber-Ep4 in the diagnosis of adenocarcinoma were 89.0%,28.6%,53.8%,98.9% and 53.8%,while the specificities of which were 4.3%,100%,95.7%,94.8% and 100%,respectively.The simultaneous positive expressions of CK7+CK20+Villin and CK7+CK20 were most commonly found in gastric adenocarcinoma, which of CK7+Villin and CK20+Villin were most commonly seen in biliary adenocarcinoma and colon adenocarcinoma.Conclusion The antibodies of CK7,CK20,Villin, MOC-31 and Ber-Ep4 can not only effectively identify adenocarcinoma in the serous effusion, but also have a good effect on judging the source of the tumor.