免疫细胞化学染色检查协助鉴别浆膜腔积液中转移性腺癌原发部位

摘要

Objective:To investigae a panel of immunohistochemical stains to help differentiate from the primary sites of metastatic adenocarcinoma in serous effusions. Methods: Thirty - one cases of metastatic adenocarcinoma in serous effusions were confirmed by histologic diagnoses and/or clinical,including 15 adenocarcinoma of lung, 10 adenocarcinoma of ovary, 6 gastrointestinal adenocarcinoma. Paraffin - embedded cell block sections were immunos-tained for TTF - 1, CA125 ,CK7 and CK20. Results; The positive expression of lung adenocarcinoma were TTF - 1 (73.3% ), CA125 (26.7% ), CK7 (73. 3% ), CK20 (0% ) ; Ovarian adenocarcinoma were positive for TTF - 1 (0% ), CA125 (70.0% ), CK7 (100.0% ) , CK20 (0% ), gastrointestinal adenocarcinoma were positive for TTF -1 (0% ) , CA125 (16.7% ) , CK7 (0% ), CK20 (100. 0% ). TTF - 1 expression in lung adenocarcinoma with high sensitivity and specificity of 73.3% , 100% , CA125 expression in ovarian adenocarcinoma had a higher sensitivity of 70.0% , the combination of CK7 negativity/CK20 positivity was seen in 100% of gastrointestinal adenocarcinoma. Conclusion; The combination of TTF - 1 ,CA125 ,CK7 and CK20 stains is useful in distinguishing metastatic adenocarcinoma in serous effusions from lung, ovary and gastrointestinal.%目的:探讨一组鉴别浆膜腔积液中转移性腺癌原发部位的抗体.方法:对31例浆膜腔积液转移性腺癌制备细胞蜡块切片作TTF-1、CA125、CK7、CK20免疫细胞化学染色,这些病例经组织学或结合临床资料证实:肺腺癌15例、卵巢腺癌10例、胃肠癌6例.结果:肺腺癌的阳性表达分别是TTF -1(73.3％)、CA125 (26.7％)、CK7(73.3％)、CK20( 0％),卵巢腺癌的阳性表达分别是TrF-1(0％)、CA125 (70.0％)、CK7( 100.0％)、CK20(0％),胃肠腺癌的阳性表达分别是TrF-1(0％)、CA125( 16.7％)、CK7(0％)、CK20(100 0％).TTF -l在肺腺癌的表达具有高度敏感性(73 3％)及特异性(100％),CA125在卵巢腺癌的表达也有较高的敏感性(70 0％),CK7(一)/CK20(+)在胃肠腺癌的表达100％.结论:联合检测TTF -1、CA125、CK7、CK20能有效鉴别浆膜腔积液中来自肺、卵巢、胃肠道的腺癌.