免疫组化在肺小活检中对肺癌组织学分型的鉴别诊断意义

摘要

目的:探讨应用免疫组织化学标记在肺小活检中提高肺癌组织学分型的鉴别诊断意义.方法:收集三家医院小活检肺癌128例,免疫组化根据形态学观察情况选用抗体包括p63、p40、CK5/6、TTF-1、NapsinA、CK7、CgA、Syn、CD56、Ki-67等标记,通过单纯形态学观察和结合免疫组化分别进行肺癌组织学分型.结果:128例肺癌中单凭形态学观察肺癌分型准确率为77.34%,结合免疫组化分型准确率为91.41%,提高了14.07%.结论:肺癌小活检标本行免疫组化检测能提高肺癌组织学分型.建议在形态学基础上综合运用一组抗体:鉴别腺癌与鳞癌时选用 TTF -1、NapsinA、CK7、p40、p63、CK5/6;倾向小细胞癌时选用 CgA、Syn、CD56、Ki-67、TTF-1、p40.%Objective:To investigate the differential diagnostic value of immunohistochemical markers in lung bi-opsy to improve the histological type of lung cancer.Methods:A total of 128 patients with small lung cancer were col-lected from three hospitals,according to the morphological observation,immunohistochemical staining was performed with antibodies and reagents including p63,p40,CK5/6,TTF-1,NapsinA,CK7,CgA,Syn,CD56,Ki-67 and so on. The histological type of lung cancer was observed by morphological observation and morphological observation com-bined with immunohistochemistry respectively.Results:In 128 cases,the accuracy rate of lung cancer classification was only 77.34%,The accuracy of typing was 91.41% in combination with immunohistochemistry,which increased 14.07%.Conclusion:Immunohistochemical staining of lung cancer with small biopsy specimens improves the histo-logical classification of lung cancer.We propose to use a set of antibodies based on morphology,differentiation of ade-nocarcinoma and squamous cell carcinoma using TTF-1,NapsinA,CK7,p40,p63,CK5/6.Consider small cell carci-noma using CgA,Syn,CD56,Ki-67,TTF-1,p40.