免疫细胞化学在浆膜腔积液病理检测中的应用价值探析

Application Value Analysis of Immunocytochemistry in Pathological Detection of Serous Cavity Effusion

目的 探讨免疫细胞化学(immunocytochemistry,ICC)应用在浆膜腔积液病理检测中的临床价值,为判断浆膜腔积液性质及临床诊断与治疗提供参考依据。方法 收集139例浆膜腔积液标本,分别予以常规细胞涂片检测与免疫细胞化学检测CEA、E-Cad、Villin、Pax-8、TTF-1、CDX2、D2-40,详细记录两种方法的检验结果,对比两种方法浆膜腔积液恶性细胞的检出情况。结果 免疫细胞化学恶性细胞检出率明显高于常规细胞涂片检测,差异有统计学意义(P<0.05);免疫细胞化学CEA、E-Cad恶性细胞高表达,Villin、Pax-8、TTF-1、CDX2提示恶性细胞消化道、卵巢、肺等来源,D2-40间皮细胞高表达,且各项肿瘤标志物联合检测的价值较单独检测价值高(P<0.05)。结论 在浆膜腔积液病理检测过程中,积极实施免疫细胞化学检测具有非常显著的价值,相较常规细胞涂片检测,免疫细胞化学检测恶性细胞检出率更高,且能够确定恶性细胞类型,提示恶性细胞来源。帮助判断疾病预后,免疫细胞化学提升了细胞学标本的价值,更解决了浆膜腔积液病理诊断的疑难,值得临床推广与应用。

Objective To explore clinical value of immunocytochemistry(ICC)in pathological detection of serous cavity effusion and provide reference for determining nature of serous cavity effusion and clinical diagnosis and treatment.Methods The paper collected 139 specimens of serous cavity effusion with routine cell smear testing and immunocytochemistry testing for CEA,E-Cad,Villin,Pax-8,TTF-1,CDX2,D2-40.Results of two methods were recorded in detail,detection of malignant cells in serous cavity effusion was compared.Result:Detection rate of malignant cells in immunocytochemistry was significantly higher than routine cell smear detection,with statistically significant difference(P<0.05).Immunocytochemistry showed high expression of CEA and E-Cad malignant cells,while Villin,Pax-8,TTF-1 and CDX2 indicated high expression of malignant cells from the digestive tract,ovaries,lungs and other sources.D2-40 mesothelial cells were also highly expressed,value of combined detection of various tumor markers was higher than individual detection(P<0.05).Conclusion In pathological detection process of serous cavity effusion,active immunocytochemistry testing can achieve significant value,with higher detection rate of malignant cells than routine cell smear testing,can determine type of malignant cells,indicate source of malignant cells and help determine disease prognosis,it can improve value of cytological specimens and solve difficulties of pathological diagnosis of serous cavity effusion,which is worthy of clinical promotion and application.