本文選題：胸水　切入點：細(xì)胞蠟塊　出處：《臨床與實驗病理學(xué)雜志》2017年03期

【摘要】：目的 探討細(xì)胞蠟塊結(jié)合免疫組化在惡性胸水的診斷及鑒別診斷中的作用,并分析胸水細(xì)胞蠟塊在肺腺癌分子病理檢測中的作用。方法 回顧性分析142例惡性胸水的液基細(xì)胞學(xué)、細(xì)胞蠟塊HE染色以及免疫組化En Vision兩步法染色,并結(jié)合細(xì)胞形態(tài)抗體的表達(dá)情況對惡性胸水進(jìn)行腫瘤分類。采用ARMS-PCR法對其中40例經(jīng)免疫組化En Vision染色確診為肺腺癌的胸水細(xì)胞蠟塊,進(jìn)行表皮生長因子受體(epidermal growth factor receptor,EGFR)基因突變檢測。結(jié)果 142例胸水細(xì)胞蠟塊經(jīng)免疫組化染色證實肺腺癌99例,肺小細(xì)胞癌4例,肺鱗狀細(xì)胞癌3例,乳腺癌13例,卵巢癌9例,胃癌2例,甲狀腺癌1例,子宮內(nèi)膜癌1例,間皮瘤5例,淋巴瘤3例,惡性黑色素瘤1例,滑膜肉瘤1例。40例肺腺癌中EGFR基因突變20例,其中19del突變9例,L858R突變11例。結(jié)論 惡性胸水細(xì)胞蠟塊行免疫組化檢測不僅有助于腫瘤的明確診斷,更有助于對腫瘤進(jìn)行分類并判斷腫瘤原發(fā)部位及幫助判斷預(yù)后。利用胸水細(xì)胞蠟塊可以對肺腺癌進(jìn)行EGFR基因突變的檢測,為肺腺癌的基因檢測提供新型的標(biāo)本來源。
[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.
【作者單位】： 西安交通大學(xué)第一附屬醫(yī)院病理科;
【分類號】：R734.2
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本文編號：1729881