摘要
目的 分析肺腺癌病理鉴别诊断中胸腔积液细胞块切片免疫组化染色法的效能。方法 纳入2022年1月至2023年10月院内诊治胸腔积液患者79例,采集胸腔积液细胞标本,分别行细胞涂片检查、细胞块切片免疫组化染色检查,观察诊断效能,包括肺腺癌免疫组化指标(BerEP4、TTF-1、CK17、CD15),间皮细胞免疫组化指标(Desmin、WT-1、CK5/6)。结果 本组79例患者中,综合病理诊断肺腺癌50例,间皮性肿瘤29例,细胞块切片检查的诊断灵敏度为96.00%,特异度为89.66%,准确率为93.67%高于细胞涂片检查方法的80.00%、62.07%、73.42%(P <0.05)。对肺腺癌诊断,细胞块切片与细胞涂片检查免疫组化染色法对Desmin、CK5/6、WT-1、CD15检出率无统计学意义(P> 0.05),细胞块切片对BerEP4、CK17检出率高于细胞涂片(P <0.05)。间皮肿瘤中,不同检测法对CK5/6、BerEP4、WT-1、CD15、CK17检出率无统计学意义(P> 0.05)。细胞块切片法对Desmin检出率高于细胞涂片法(P <0.05)。结论 通过胸腔积液检查进行肺腺癌与间皮肿瘤鉴别诊断中,与细胞涂片法对比,细胞块切片免疫组化染色法诊断效能更高,有助于提高临床诊断灵敏度与特异度,其中BerEP4、CK17对肺癌诊断价值较高,Desmin对间皮肿瘤诊断价值较高。
Objective To analyze the efficacy of immunohistochemical staining method for pleural effusion cell block sections in pathological differential diagnosis of lung adenocarcinoma.Methods Seventy-nine patients with pleural effusion who were diagnosed and treated in the hospital between January 2021 and October 2023 were included.Cell samples of pleural effusion were collected and subjected to cell smear examination and immunohistochemical staining of cell block sections to observe diagnostic efficacy.Immunohistochemical indicators of lung adenocarcinoma(BerEP4,TTF-1,CK17,CD15)and mesothelial cell immunohistochemistry(Desmin,WT-1,CK5/6)were included.Results Among the 79 patients in this group,50 cases of lung adenocarcinoma and 29 cases of mesothelic tumor were diagnosed by comprehensive pathology.The diagnostic sensitivity,specificity and accuracy of cell slice examination were 96.00%,89.66%and 93.67%,respectively,higher than that of cell smear examination 80.00%,62.07%and 73.42%(P<0.05).For the diagnosis of lung adenocarcinoma,the detection rates of Desmin,CK5/6,WT-1 and CD15 by immunohistochemical staining were not statistically significant(P>0.05),but the detection rates of BerEP4 and CK17 were higher in cell slice than in cell smear(P<0.05).In mesothelial tumors,the detection rates of CK5/6,BerEP4,WT-1,CD15 and CK17 were not statistically significant(P>0.05).The detection rate of Desmin by cell slice was higher than that by cell smear(P<0.05).Conclusions In the differential diagnosis of lung adenocarcinoma and mesothelial tumors through pleural effusion examination,compared with cell smear method,cell block section immunohistochemical staining method has higher diagnostic efficiency,which helps to improve clinical diagnostic sensitivity and specificity.BerEP4 and CK17 have higher diagnostic value for lung cancer,while Desmin has higher diagnostic value for mesothelial tumors.
作者
潘之楠
阮顺爱
PAN Zhinan;RUAN Shun'ai(Department of Pathology,Putian First Hospital of Fujian Province,Putian 351100,China)
出处
《中国医药指南》
2024年第27期8-10,共3页
Guide of China Medicine
关键词
肺腺癌
鉴别诊断
胸腔积液
细胞块切片免疫组化染色法
诊断效能
Lung adenocarcinoma
Differential diagnosis
Thoracic effusion
Immunohistochemical staining of cell block sections
Diagnostic efficacy
