浅表淋巴结疾病诊断中超声辅助穿刺活检结合免疫组化检验的意义

目的探讨超声辅助穿刺活检与免疫组化检验方案结合对浅表淋巴结疾病患者诊断的临床价值。方法选择2019年1月—2023年12月厦门大学附属第一医院杏林院区就诊的96例疑似浅表淋巴结疾病患者为研究对象。患者入院后,均进行超声辅助穿刺活检和免疫组化检验,以术后病理学结果作为金标准。比较两种方法阳性病例检出情况、灵敏度、特异度、准确度、阳性预测值、阴性预测值。结果术后病理学结果显示阳性病例92例,阳性率为95.83%(92/96)。超声辅助穿刺活检结合免疫组化检验诊断的阳性率高于单纯穿刺活检,差异有统计学意义(P<0.05)。超声辅助穿刺活检结合免疫组化检验诊断的灵敏度为96.74%(89/92)、特异度为100.00%(4/4)、准确度为96.88%(93/96),高于单纯穿刺活检的69.57%(64/92)、50.00%(2/4)、68.75%(66/96),差异有统计学意义(χ^(2)=17.710、24.246、10.643,P均<0.05)。超声辅助穿刺活检结合免疫组化检验诊断的阳性预测值为100.00%(89/89)、阴性预测值为57.14%(4/7),与单纯穿刺活检的96.97%(64/66)、6.67%(2/30)比较,差异无统计学意义(χ^(2)=2.667、2.732,P均>0.05)。结论超声辅助穿刺活检结合免疫组化检验方案在浅表淋巴结疾病诊断中,具有较高诊断效能。

肺小活检中应用免疫组化检验对腺癌及鳞状细胞癌的鉴别诊断价值

目的:探讨肺小活检中应用免疫组化检验对腺癌及鳞状细胞癌的鉴别诊断价值。方法:自2014年3月至2018年3月间26例肺原发性鳞状细胞癌、51例肺原发性腺癌患者的活检标本进行研究,测定细胞角蛋白5/6(CK5/6)、p63、napsinA以及甲状腺转录因子1(TTF-1)的表达,分析该4种标记物在腺癌和鳞状细胞癌诊断中的阳性率。结果:鳞状细胞癌患者组中CK5/6阳性率为96.15%,p63的阳性率为100.00%,高于napsinA、TTF-1(P<0.05);腺癌患者中napsinA和TTF-1的阳性率分别为100.00%、98.04%,高于CK5/6和p63(P<0.05)。结论:p63和CK5/6在鳞状细胞癌检测中有较大优势,napsinA和TTF-1在腺癌诊断的阳性率较高,因此在腺癌和鳞状细胞癌的诊断鉴别中可联合该4项指标进行综合评判,提升诊断准确率。

肝脏穿刺组织病理检查使用免疫组化检验技术对提高确诊率的价值解析

目的 研究肝脏穿刺组织病理检查使用免疫组化检验技术对于提高确诊率的价值。方法 选取86例2020年3月—2021年3月在濮阳市中医医院接受肝脏穿刺组织病理检查的患者,随机进行分组,A组(n=43),行肝脏穿刺组织病理检查以常规HE染色技术对病理切片进行染色,B组(n=43),采用免疫组化检验技术进行病理切片染色,总结分析两组切片染色的质量与疾病诊断准确率。结果 B组患者病理切片染色质量优良率为97.67%,与A组的83.72%对比差异有统计学意义(P<0.05);且B组疾病诊断的准确率(95.34%)与A组的(81.39%)比较也明显增高,差异有统计学意义(P<0.05)。结论 对于开展肝脏穿刺组织病理检查的患者,以免疫组化检验技术对其病理切片进行染色,可有效优化切片染色的质量,提高疾病诊断准确率。

免疫组化病理技术及质量控制方式的研究

目的:研究免疫组化病理技术及质量控制方法。方法:从2018年4月至2019年12月间,我院收治的胃肠肿瘤患者中选取150例,数表法随机分成两组:对照组、试验组均为75例。对照组实施常规免疫组化检验技术,试验组采用PDCA循环法进行质量控制。比较两组制片优良率和病理诊断结果,评价免疫组化检验质量。结果:试验组制片优良率为98.67%,病理诊断的确诊率为97.33%,比对照组的90.67%、88.00%要高,有显著性差异(P<0.05)。相比于对照组,试验组在切片、染色、固定等操作环节的质量评分更高(P<0.05)。结论:采用免疫组化病理技术进行检验时,实施PDCA循环进行质量控制能提高制片优良率和确诊率,促进检验质量不断提升。

111例胃肠道间质瘤患者的临床资料分析

目的:分析111例胃肠道间质瘤(GIST)患者的临床资料,探讨其临床特征。方法:在江苏省中医院电子病历系统及病理报告系统中选取2015年1月至2019年12月期间确诊为GIST的111例患者作为研究对象。回顾性分析这些患者的临床资料,了解其所患疾病的临床特征、病理组织学特征及免疫组化检验结果。结果:在这些患者中,男性占43.24%,女性占56.76%;年龄<40岁的患者占5.41%,年龄为41~60岁的患者占45.95%,年龄>60岁的患者占48.65%;发病部位为胃部的患者占84.68%,为小肠的患者占13.51%,为直肠的患者占1.80%;肿瘤最大径<1 cm的患者占41.44%,肿瘤最大径为1~4 cm的患者占52.25%,肿瘤最大径>4 cm的患者占6.31%;核分裂象≤5个/50高倍视野(HPF)的患者占90.99%,核分裂象为6~10个/50 HPF的患者占8.11%,核分裂象>10个/50 HPF的患者占0.90%;GIST危险度分级为极低危的患者占63.96%,为低危的患者占19.82%,为中危的患者占9.91%,为高危的患者占6.31%。对这些患者进行免疫组化检验的结果显示,细胞分化因子34(CD34)、细胞分化因子117(CD117)、功能未知蛋白(DOG1)的阳性检出率分别为96.40%、98.20%、98.20%。结论:这些GIST患者多为中老年人,其发病部位主要为胃部,肿瘤的最大径多为1~4 cm或<1 cm,GIST危险度分级多为极低危。其中,多数患者的核分裂象≤5个/50 HPF,经免疫组化检验其CD34、CD117、DOG1多呈阳性。

B淋巴母细胞淋巴瘤脑转移误诊弥漫性轴索损伤尸检1例

由于弥漫性轴索损伤在大体及普通组织病理学检查无明显病变,所以DAI长期是法医病理学中非常棘手的死因诊断,如果合并其它脑部疾病,诊断则更为困难.本文报道一例头部损伤被误诊为弥漫性轴索损伤（diffuse axonal injury,DAI）,而尸检证实为B淋巴母细胞淋巴瘤脑转移死亡的案例,并结合相关文献对其法医病理学鉴定注意事项进行讨论.

Preparation of monoclonal antibody to P53 and its clinical application

Objective：The aim of this study was to prepare monoclonal antibody against P53, a kind of tumor suppressor protein,and use the antibody initial y in clinical immunoassay. Methods：Monoclonal antibody was prepared and identified via the classic protocol of monoclonal antibody preparation. Identified monoclonal antibodies were purified by af inity chro-matography. Antibody titer was determined by enzyme linked immunosorbent assay （ELISA）. The specific binding activity of antibody was detected by Western blotting and immunohistochemistry. Results：Three strains of monoclonal antibodies named 1P15, 2P37 and 3P40 were obtained and purified by af inity chromatography. The purity of antibodies was higher than 90%. The titers of antibodies were more than 1：6000. Western blot and immunohistochemistry assay showed that the specific antibody can combine with endogenous P53 protein in the tumor celllines and determine the expression of P53 in tumor tis-sue. Conclusion：Three strains of monoclonal antibodies with high af inity to P53 were successful y established, which can be used for detecting the expression of P53 in tumor cells or tissue.

Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis

AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB.