Calretinin、CEA标记在胸腹腔积液细胞学诊断中的应用

目的 :探讨calretinin、CEA免疫细胞化学标记对浆膜腔积液中正常、反应性间皮细胞与转移性癌细胞的鉴别诊断价值。方法 :59例胸腹腔积液标本 ,采用常规HE染色、CEA及calretinin免疫细胞化学标记。最后诊断通过活检、随访等确立。结果 :最后诊断转移癌 1 7例、良性者 37例、未确定 5例。Calretinin对间皮细胞标记的阳性率为 94.6 % (35/ 37) [86 .5 % (32 / 37) ,强阳性 ] ,转移癌细胞 2 3 .5 % (4/ 1 7)阳性 [5 .9% (1 / 1 7)强阳性 ] ;CEA对转移癌细胞标记的阳性率为 88.4 % (1 5/ 1 7) [52 .9% (9/ 1 7)强阳性 ] ,良性间皮细胞 43 .2 % (1 6/ 37)阳性 [1 3 .5 % (5/1 7)强阳性 ]。 1 7例转移癌中 ,1 1例calretinin、CEA两项标记支持转移癌诊断 ;良性组中 ,CEA标记有较多假阳性。结论 :CEA的特异性相对较差 ,calretinin对间皮细胞标记的特异性、敏感性较高。结果判定时 ,强阳性结果较弱阳性结果有意义 ,calretinin结果较CEA更有价值。认真细致的形态学观察 ,辅以calretinin及CEA标记 。

Immunoscintigraphy of local recurrent rectal cancer with^(99m)Tc-labeled anti-CEA monoclonal antibody CL58

AIM: To explore a specific diagnostic method for local recurrent rectal cancer.METHODS: Immunoscintigraphy with 99mTc-labeled anti-CEA monoclonal antibody (MoAb) CL-58 was performed for patients suspected of having a postoperative local recurrent rectal cancer and the findings were compared with the results of conventional imaging and pathology.RESULTS: A total of 36 patients with a suspected local recurrent rectal cancer underwent immunoscintigraphy with 99mTc-conjugated CL58. Local recurrence of rectal cancer was identified in 31 patients and established in 30 during operation, endoscopy and pathological examination. No local recurrence was found in 5 patients without specific accumulation of 99mTc during the follow-up. Immunoscintigraphy had a positive rate of 86.11%, a specificity of 83.33%, and a sensitivity of 100%.CONCLUSION: Immunoscintigraphy has a highly specific and predictive value for detecting local recurrent rectal cancer, especially after abdominal perineal resection (APR).

胸水中肿瘤标记物CEA,CA125测定在肺部恶性肿瘤中诊断价值

目的:血清CEA,CA125已被广泛应用于临床多种肿瘤的诊断和预后检测中。本文旨意在探讨检测胸水CEA,CA125在良恶性胸腔积液鉴别诊断中的临床价值。方法:同时收集64例肺癌患者的血清及胸腔积液的标本,其中腺癌29例,鳞癌24例,小细胞未分化癌11例;肺部良性病变62例作对照组。采用ABBOTT公司提供的AXSYM型全自动免疫分析仪进行检测。结果:肺癌组血清和胸水CEA,CA125的测定值高于对照组(P<0.01),有显著性差异;肺癌组胸水CEA,CA125水平明显高于血清水平(P<0.01),差异有显著性;肺癌组胸水CEA,CA125阳性率分别为67.2%,57.8%,与对照组阳性率(分别为11.3%,9.7%)比较差别均有统计学意义(P<0.01)。结论:胸水中CEA,CA125检测有利于良恶性胸腔积液的鉴别诊断,且胸水中CEA,CA125比血清中更具有临床价值。