CK、CD99等在卵巢恶性肿瘤鉴别诊断中的意义

发布时间：2018-05-08 04:25

本文选题：卵巢支持-间质细胞瘤 + 免疫组化　；参考：《山东大学》2014年硕士论文

【摘要】：目的近几年来,免疫组织化学技术发展迅速且应用普遍,免疫组化指标对肿瘤诊断具有高度的敏感性和特异性,在临床上对肿瘤的诊断、鉴别诊断、评估、分期、治疗、及预后有着重要的指导意义和应用价值。本次实验研究通过免疫组织化学技术分析CK、Vimentin、ER、PR、CD9、Inhibin-α、Calretinin等7种免疫组化指标在卵巢支持-间质细胞瘤与卵巢子宫内膜样腺癌中的表达,对其不同表达率进行统计学处理,明确这些免疫组化指标在两种不同肿瘤诊断中的应用价值及鉴别诊断意义。方法选取我院病理科2008年1月～2011年12月常规石蜡切片病理诊断为Sertoli-Leydig细胞瘤的石蜡标本44例为实验组,选取2008年1月～2011年12月常规石蜡切片病理诊断为卵巢子宫内膜样腺癌的石蜡标本44例为对照组,进行常规石蜡制片,用CK、Vimentin、ER、PR、CD99、Inhibin-α、Calretinin进行免疫组化染色,然后对免疫组化染色结果进行镜下观察,记录染色结果,统计这些不同指标表达的阳性率,运用统计学方法对这七种免疫组化指标在卵巢支持-间质细胞瘤和卵巢子宫内膜样腺癌细胞中的不同表达率进行处理分析,并对常见的与Sertoli-Leydig细胞瘤容易在形态学上相互混淆的卵巢内膜样腺癌的相同免疫组化指标的表达情况进行对比,明确这些免疫指标在两种不同肿瘤诊断及鉴别诊断中的意义。结果 CK、Vimentin、ER、PR、CD99、Inhibin-α、Calretinin等7种免疫组化指标是免疫组织化学中常用的标记物,从组织细胞水平进行抗原抗体反应,标记抗体和显色剂特殊显色来确定组织细胞内的抗原(蛋白质及多肽),对其进行定位、定性及定量,敏感性高,定位准确,临床应用意义极大。在本实验研究中,免疫组化指标CK、ER、PR、Inhibin-α、Calretinin及CD99在卵巢支持-间质细胞瘤和卵巢子宫内膜样腺癌细胞两种不同肿瘤细胞中的表达率差异具有显而易见的统计学意义,而Vimentin在以上两种肿瘤细胞中的表达率差异无明显统计学意义,换句话说,在应用免疫组化鉴定两种细胞的来源上Calretinin、CD99、 CK、Inhibin-α、ER及PR可以作为一组免疫指标,在两种不同肿瘤的诊断及鉴别诊断中具有举足轻重的意义。结论免疫组化指标Calretinin、CD99、CK、Inhibin-α、ER、PR在卵巢支持-间质细胞瘤和卵巢子宫内膜样腺癌的表达率差异有明显的统计学意义,在这两种不同肿瘤的诊断及鉴别诊断中具有重要意义和临床应用价值；而Vimentin在以上两种肿瘤细胞中的表达率差异无明显统计学意义,即此种免疫组化指标在卵巢支持-间质细胞瘤和卵巢子宫内膜样腺癌的鉴别诊断中意义不大。
[Abstract]:Purpose In recent years, the immunohistochemical technique has developed rapidly and is widely used. The immunohistochemical index has a high sensitivity and specificity to the diagnosis of tumor, the diagnosis, differential diagnosis, evaluation, staging and treatment of tumor in clinic. And prognosis has important guiding significance and application value. In this study, immunohistochemical technique was used to analyze the expression of seven immunohistochemical indexes, including CKP Vimentinerian PRT CD9, Inhibin- 伪 and Calretinin, in ovarian Sertoli stromal cell tumor and endometrioid adenocarcinoma of ovary, and the different expression rates were analyzed statistically. To determine the value of these immunohistochemical markers in the diagnosis of two different tumors and the significance of differential diagnosis. Method From January 2008 to December 2011, 44 paraffin wax specimens diagnosed as Sertoli-Leydig cell tumor by routine paraffin section in our department of pathology were selected as experimental group. From January 2008 to December 2011, 44 paraffin specimens of ovarian endometrioid adenocarcinoma diagnosed as ovarian endometrioid adenocarcinoma by pathology from January 2008 to December 2011 were selected as control group. The specimens were prepared by routine paraffin wax, and the immunohistochemical staining was performed with CK Vimentin ERP CD99 / Inhibin- 伪 Calretinin. Then the immunohistochemical staining results were observed under microscope, the staining results were recorded, and the positive rates of the expression of these different indicators were counted. The different expression rates of these seven immunohistochemical markers in ovarian Sertoli stromal cell tumor and ovarian endometrial adenocarcinoma were analyzed by statistical method. The expression of the same immunocytochemical markers in ovarian endometrioid adenocarcinoma, which is easily confused in morphology with Sertoli-Leydig cell tumor, was compared, and the significance of these immunological markers in the diagnosis and differential diagnosis of two different tumors was determined. Result Seven immunocytochemical markers, such as CKVimentinerian, CD99, Inhibin- 伪 and Calretinin, are commonly used as markers in immunohistochemistry, and the antigen-antibody reaction is carried out at the histocyte level. To determine the antigen (protein and polypeptide) in tissue cells by special coloration of antibody and chromogenic agent, the localization, qualitative and quantitative analysis, high sensitivity, accurate location and great clinical application significance. In this study, the expression rates of CD99 and CD99 in ovarian Sertoli stromal cell tumor and ovarian endometrial adenocarcinoma cell line were significantly different, and the difference was statistically significant in the expression of CKERERP / Inhibin- 伪 Calretinin and CD99 in ovarian Sertoli stromal cell tumor and ovarian endometrial adenocarcinoma cell line. But there was no significant difference in the expression rate of Vimentin between the two kinds of tumor cells. In other words, Calretinin CD99, CKP Inhibin- 伪 ER and PR could be used as a group of immunological markers in identifying the origin of the two kinds of cells by immunohistochemistry. It plays an important role in the diagnosis and differential diagnosis of two different tumors. Conclusion The expression rate of CKInhibin- 伪 ERPR in ovarian Sertoli Leydig cell tumor and endometrioid adenocarcinoma was significantly different from that of Calretininus CD99, and had important significance and clinical application value in the diagnosis and differential diagnosis of these two kinds of tumors. However, there was no significant difference in the expression rate of Vimentin between the above two types of tumor cells, that is, this immunohistochemical index was of little significance in the differential diagnosis of ovarian Sertoli stromal cell tumor and ovarian endometrioid adenocarcinoma.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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