细胞块技术在恶性浆膜腔积液组织来源及分子病理检测中的应用

目的 探讨细胞块免疫组化技术在恶性浆膜腔积液组织来源及分子病理检测中的应用价值。 方法 抽取 42 例患者 的恶性浆膜腔积液，分层离心获取肿瘤细胞并制作成细胞蜡块，应用 HE 染色、免疫组化染色、基因测序等方法对其进行检测。 结果42 例患者中，利用恶性浆膜腔积液细胞块明确组织分型及组织来源 40 例，其中肺癌 29 例（腺癌 24 例、鳞癌 3 例、小细胞癌 2 例），恶 性淋巴瘤 2 例，胃肠道癌 4 例，乳腺癌 4 例，卵巢癌 1 例。29 例肺癌样本中 24 例进行了肺腺癌基因检测，其中 9 例表皮生长因子受体 基因突变，包括 E19（del E746-A750）缺失突变 6 例和 E21（L858R）替代突变 3 例。 结论 细胞块技术对于恶性浆膜腔积液的诊断 有重要临床意义，有助于明确诊断并查找组织来源，同时能够进行组织分型及分子病理检测，有效指导肿瘤的分子靶向治疗。

Application of serous cavity effusion cell block in histopathological and molecular pathological examinations

Objective Application of cell block from malignant serous cavity effusion in histopathological and molecular pathological examinations. Methods Forty-two samples of malignant serous cavity effusion were centrifugalized and the tumor cells were obtained for cell block, the hematoxylin and eosin (HE) staining, immunohistochemical staining, gene sequencing were used for investigation. Results Among 42 cell blocks, the histological types and tissue sources were confirmed in 40, including 29 cases of lung cancer (24 adenocarcinoma, 3 squamous cell carcinomas and 2 small cell carcinoma), 2 cases of malignant lymphoma, 4 cases of gastrointestinal carcinoma, 4 cases of breast cancer and 1 case of ovarian cancer. Twenty four specimens of lung adenocarcinoma were subjected to genetic tests and 9 were found with EGFR gene mutations, including 6 cases of E19 (del E746-A750) and 3 cases of E21 (L858R). Conclusion Serous cavity effusion cell block technique is of value in histopathological diagnosis and tumor targeted therapy.