免疫组织化学联合抗体在浆膜腔积液中的诊断作用

Diagnostic role of immunocytochemistry combined with antibody in serous cavity effusion

目的探讨免疫组织化学联合抗体在浆膜腔积液中鉴别增生性间皮细胞和转移性腺癌细胞的应用价值。方法选取2017-2020年该院病理科收集的有增生性间皮细胞及腺癌细胞的浆膜腔积液标本208例,采用细胞石蜡技术并进一步运用免疫组织化学标记方法检测特异性抗体CEA、MOC-31、Ber-Ep4、CK5/6、WT1、Calretinin的表达水平。选取的恶性浆膜腔积液病例均经常规细胞学检出恶性肿瘤细胞,且细胞学诊断均与临床诊断或原发灶组织病理学诊断相符。其中转移性腺癌135例,反应性增生间皮细胞71例,间皮瘤2例。结果间皮细胞与腺癌细胞本身有质的区别,但在细胞学诊断中增生性间皮细胞与腺癌细胞单从形态上常难以分辨。增生性间皮细胞CEA、MOC-31、Ber-Ep4、CK5/6、Calretinin、WT1的表达水平与腺癌细胞比较,差异均有统计学意义(P<0.05)。结论应用细胞石蜡技术结合免疫组织化学联合抗体检测对鉴别浆膜腔积液中增生性间皮细胞与转移性腺癌细胞有极大帮助,在细胞病理学诊断中具有极高的应用价值。

Objective To investigate the application value of immunocytochemistry combined with antibody on the differential diagnosis between proliferative mesothelial cells and metastatic adenocarcinoma cells in serous cavity.Methods A total of 208 serosal cavity effusion specimens with proliferative mesothelial and adenocarcinoma cells were collected from the pathology department of this hospital from 2017 to 2020.The expression of specific antibodies CEA,MOC-31,Ber-Ep4,CK5/6,WT1 and Calretinin were detected by cell paraffin technology and immunocytochemical labeling.Malignant tumor cells were detected by routine cytology in all cases of malignant serosal effusion,and the cytological diagnosis was consistent with clinical diagnosis or primary histopathological diagnosis.There were 135 cases of metastatic adenocarcinoma,71 cases of reactive hyperplasia mesothelioma and two cases of mesothelioma.Results There are qualitative differences between mesothelial cells and adenocarcinoma cells,but it is often difficult to distinguish proliferative mesothelial cells from adenocarcinoma cells in cytological diagnosis.The expressions of CEA,MOC-31,Ber-Ep4,CK5/6,Calretinin and WT1 in proliferative mesothelial cells were compared with those of adenocarcinoma cells,and the differences were statistically significant(P<0.05).Conclusion The use of cell paraffin technology combined with immunocytochemistry and antibody detection is of great help in differentiating proliferative mesothelial cells from metastatic adenocarcinoma cells in serosal effusion,and has high application value in cytopathological diagnosis.