142例恶性胸水细胞蜡块的免疫组化检测及分子病理检测

发布时间：2018-04-10 05:31

  本文选题：胸水　切入点：细胞蜡块　出处：《临床与实验病理学杂志》2017年03期

【摘要】：目的 探讨细胞蜡块结合免疫组化在恶性胸水的诊断及鉴别诊断中的作用,并分析胸水细胞蜡块在肺腺癌分子病理检测中的作用。方法 回顾性分析142例恶性胸水的液基细胞学、细胞蜡块HE染色以及免疫组化En Vision两步法染色,并结合细胞形态抗体的表达情况对恶性胸水进行肿瘤分类。采用ARMS-PCR法对其中40例经免疫组化En Vision染色确诊为肺腺癌的胸水细胞蜡块,进行表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变检测。结果 142例胸水细胞蜡块经免疫组化染色证实肺腺癌99例,肺小细胞癌4例,肺鳞状细胞癌3例,乳腺癌13例,卵巢癌9例,胃癌2例,甲状腺癌1例,子宫内膜癌1例,间皮瘤5例,淋巴瘤3例,恶性黑色素瘤1例,滑膜肉瘤1例。40例肺腺癌中EGFR基因突变20例,其中19del突变9例,L858R突变11例。结论 恶性胸水细胞蜡块行免疫组化检测不仅有助于肿瘤的明确诊断,更有助于对肿瘤进行分类并判断肿瘤原发部位及帮助判断预后。利用胸水细胞蜡块可以对肺腺癌进行EGFR基因突变的检测,为肺腺癌的基因检测提供新型的标本来源。
[Abstract]:Objective to investigate the role of cell wax block combined with immunohistochemistry in the diagnosis and differential diagnosis of malignant pleural effusion, and to analyze the role of cell wax mass in the molecular pathological detection of lung adenocarcinoma.Methods fluid based cytology, paraffin HE staining and immunohistochemical en Vision staining were retrospectively analyzed in 142 cases of malignant pleural effusion. The malignant pleural effusion was classified with the expression of cellular morphological antibody.ARMS-PCR method was used to detect epidermal growth factor receptor (EGFR) gene mutation in 40 cases of lung adenocarcinoma diagnosed by immunohistochemical en Vision staining.Results in 142 cases of pleural effusion, 99 cases of adenocarcinoma, 4 cases of small cell carcinoma, 3 cases of squamous cell carcinoma, 13 cases of breast cancer, 9 cases of ovarian cancer, 2 cases of gastric cancer, 1 case of thyroid carcinoma and 1 case of endometrial carcinoma were confirmed by immunohistochemical staining.There were 5 cases of mesothelioma, 3 cases of lymphoma, 1 case of malignant melanoma, 1 case of synovial sarcoma and 1 case of lung adenocarcinoma. There were 20 cases of EGFR gene mutation, including 9 cases of 19del mutation and 11 cases of L858R mutation.Conclusion Immunohistochemical examination of malignant pleural effusion cells is not only helpful for the definite diagnosis of the tumor, but also helpful for the classification of the tumor and the judgement of the primary location of the tumor and the prognosis.The EGFR gene mutation of lung adenocarcinoma can be detected by using hydrothorax cell wax mass, which provides a new sample source for gene detection of lung adenocarcinoma.
【作者单位】： 西安交通大学第一附属医院病理科;
【分类号】：R734.2
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本文编号：1729881