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1.
B72.3和Ber-EP4及calretinin在浆膜腔积液鉴别诊断中的应用   总被引:2,自引:0,他引:2  
目的评价B72.3、BerEP4和calretinin对浆膜腔积液中癌细胞和增生间皮细胞的鉴别诊断价值,并探讨ThinPrep薄片(TP)作为免疫细胞化学(ICC)制片方法的可行性。方法选择158例浆膜腔积液标本做石蜡包埋细胞块(CB)切片ICC(CBICC),评价B72.3、BerEP4和calretinin的诊断效果。对其中49例同时做TP的ICC(TPICC),并与CBICC的结果进行比较分析。结果B72.3和BerEP4诊断癌细胞的敏感性分别为76.9%和69.2%,两者结合的敏感性增至89.7%。calretinin对间皮细胞的敏感性为90.9%,特异性为87.2%。B72.3在CBICC和TPICC中诊断癌细胞的敏感性分别为78.9%和68.4%,差异无统计学意义;BerEP4的敏感性分别为78.9%和84.2%,差异也无统计学意义。结论B72.3、BerEP4和calretinin组合能有效辅助细胞学鉴别诊断癌细胞与增生间皮细胞;在浆膜腔积液癌细胞与增生间皮细胞的鉴别诊断中,TP可以替代CB。  相似文献   

2.
苏学英  李甘地  刘华兵  蒋莉莉 《癌症》2004,23(10):1185-1189
背景与目的:浆膜腔积液中转移性腺癌细胞、恶性上皮型间皮瘤细胞和反应性间皮细胞的形态有不少相似之处,有时仅凭形态学特征不能做出准确诊断.近年来免疫细胞化学在这方面得到较多应用,但国内报道仅局限于用CK、EMA、CEA、Vim和HBME-1几种抗体,而且不能较好地进行细胞学的鉴别诊断.本研究旨在探讨联合检测E-cadherin、CEA及calretinin在浆膜腔积液鉴别诊断中的应用价值.方法:选用浆膜腔积液标本共93例,其中胸水66例、腹水24例、心包积液3例.经组织学检查或结合临床资料证实的转移性腺癌55例、恶性上皮型间皮瘤6例、间皮细胞反应性增生32例.每例均制备HE染色的涂片和细胞块,并用细胞块切片作免疫细胞化学染色.结果:E-cadherin、CEA对诊断转移性腺癌的敏感性分别为85.5%(47/55)、78.2%(43/55),特异性分别为100%(38/38)、97.4%(37/38).E-cadherin 和CEA联合应用诊断浆膜腔积液转移性腺癌的阳性率为96.4%(53/55).Calretinin 对诊断间皮瘤和间皮细胞增生的敏感性和特异性分别为81.6%(31/38)和87.2%(48/55).结论:E-cadherin、CEA和calretinin是鉴别浆膜腔积液转移性腺癌细胞和间皮源性细胞有价值的一组抗体.  相似文献   

3.
目的评价B72.3、Ber-EP4和calretinin对浆膜腔积液中癌细胞和增生间皮细胞的鉴别诊断价值,并探讨ThinPrep薄片(TP)作为免疫细胞化学(ICC)制片方法的可行性。方法选择158例浆膜腔积液标本做石蜡包埋细胞块(CB)切片ICC(CB—ICC),评价B72.3、Ber-EP4和calretinin的诊断效果。对其中49例同时做TP的ICC(TP-ICC),并与CB—ICC的结果进行比较分析。结果B72.3和BerEP4诊断癌细胞的敏感性分别为76.9%和69.2%,两者结合的敏感性增至89.7%。calretinin对问皮细胞的敏感性为90.9%,特异性为87.2%.B72.3在CB-ICC和TP-ICC中诊断癌细胞的敏感性分别为78.9%和68.4%,差异无统汁学意义;Ber-EP4的敏感性分别为78.9%和84.2%,差异也无统计学意义。结论B72.3、Ber-EP4和calretinin组合能有效辅助细胞学鉴别诊断癌细胞与增生间皮细胞;在浆膜腔积液癌细胞与增生间皮细胞的搭别诊断中,TP可以替代CB。  相似文献   

4.
背景与目的:浆膜腔积液中转移性腺癌细胞、恶性上皮型间皮瘤细胞和反应性间皮细胞的形态有不少相似之处,有时仅凭形态学特征不能做出准确诊断。近年来免疫细胞化学在这方面得到较多应用,但国内报道仅局限于用CK、EMA、CEA、Vim和HBME-1几种抗体,而且不能较好地进行细胞学的鉴别诊断。本研究旨在探讨联合检测E-cadherin、CEA及calretinin在浆膜腔积液鉴别诊断中的应用价值。方法:选用浆膜腔积液标本共93例,其中胸水66例、腹水24例、心包积液3例。经组织学检查或结合临床资料证实的转移性腺癌55例、恶性上皮型间皮瘤6例、间皮细胞反应性增生32例。每例均制备HE染色的涂片和细胞块,并用细胞块切片作免疫细胞化学染色。结果:E-cadherin、CEA对诊断转移性腺癌的敏感性分别为85.5%(47/55)、78.2%(43/55),特异性分别为100%(38/38)、97.4%(37/38)。E-cadherin和CEA联合应用诊断浆膜腔积液转移性腺癌的阳性率为96.4%(53/55)。Calretinin对诊断间皮瘤和间皮细胞增生的敏感性和特异性分别为81.6%(31/38)和87.2%(48/55)。结论:E-cadherin、CEA和calretinin是鉴别浆膜腔积液转移性腺癌细胞和间皮源性细胞有价值的一组抗体。  相似文献   

5.
免疫细胞化学鉴别良恶性体腔积液的抗体选择和组合   总被引:1,自引:0,他引:1  
目的 优化免疫细胞化学鉴别良、恶性体腔积液的抗体选择和组合.方法 对病理学诊断明确的67例恶性和22例良性体腔积液标本采用石蜡细胞块和免疫细胞化学技术检测13种抗体.单因素方法分析每个抗体的敏感性和特异性.Logistic回归分析不同抗体组合对良、恶性体腔积液诊断的准确性.结果 检测体腔积液内肿瘤细胞敏感性最高的抗体是E-cadherin,为85.1%.其次是BerEP4和CK7,敏感性分别为82.1%和80.6%.检测肿瘤细胞特异性最强的抗体是E-cadherin、BerEP4和CK20,特异性均达到100%.Calretinin检测间皮细胞的敏感性和特异性分别为100%和95.5%,Desmin检测间皮细胞的敏感性和特异性分别为90.9%和100%.Logistic回归分析显示Calretinin是统计学上判断良、恶性体腔积液最佳的单个抗体,Calretinin和E-cadherin是区分良、恶性体腔积液最有效率的抗体组合.结论 结合单因素和多因素分析结果,我们推荐E-cadherin、BerEP4、Calretinin和Desmin作为日常免疫细胞化学鉴别良、恶性体腔积液的抗体组合.  相似文献   

6.
目的 :探讨 Ki- 6 7抗体对鉴别浆膜腔积液中良恶性细胞的价值 ,解决伴浆膜腔积液的疑难病例的诊断。方法 :用 Ki- 6 7单克隆抗体标记 4 7例浆膜腔积液涂片标本 ,每张涂片计数 10 0 0个细胞中的阳性细胞数 ,用百分率表示阳性指数 ,同时对涂片作 HE染色。结果 :恶性积液组 Ki- 6 7指数为 34.89% ,良性组为 0 .72 % ,两者差异具有显著性 (P<0 .0 0 5 )。结论 :浆膜腔积液涂片 HE染色诊断结合 Ki- 6 7标记 ,可提高恶性浆膜腔积液细胞学的阳性诊断率 ,可作为临床鉴别良恶性浆膜腔积液的参考指标。  相似文献   

7.
目的 探讨浆膜腔积液腺癌细胞和间皮细胞中Calretinin、CEA、p5 3、c erbB 2的表达及其意义。方法 应用细胞块免疫细胞化学方法,检测45例浆膜腔积液腺癌细胞和间皮细胞中Calretinin、CEA、p5 3、c- erbB- 2的表达水平。结果 Calretinin、CEA、p5 3、c erbB 2在腺癌细胞中阳性表达率分别为4% (1/2 6)、5 4% (14 /2 6)、69% (18/2 6)和77% (2 0 /2 6) ,间皮细胞中分别为79 % (15 /19)、16% (3 /19)、5 % (1/19)和2 1% (4 /19)。该4种标志物在腺癌细胞中阳性表达率与在间皮细胞中阳性表达率比较均有非常显著性差异(P <0 .0 1)。结论 Calretinin、CEA、p5 3、c- erbB- 2抗体联合检测可辅助鉴别腺癌细胞和间皮细胞。  相似文献   

8.
目的探讨免疫细胞化学技术对浆膜腔积液内转移性腺癌细胞的诊断价值.方法应用癌胚抗原(CEA)、细胞角蛋白(CK)及波形蛋白(VIM)3种标记物,对56例浆膜腔积液内的细胞进行了免疫细胞化学观察.结果CEA的敏感性91.70%、特异性75.00%、准确度82.14%;CK的敏感性87.50%、特异性31.25%、准确度55.36%;VIM的敏感性90.63%、特异性83.33%、准确度87.50%.结论免疫细胞化学CEA和VIM染色联合应用对浆膜腔积液内转移性腺癌细胞的诊断及鉴别诊断有重要的参考价值.  相似文献   

9.
目的探讨细胞图像DNA倍体分析(DNA-ICM)在恶性胸腔积液病理诊断中的应用价值。方法回顾性病例系列研究。回顾性分析山西白求恩医院2021年10月至12月101例胸腔积液患者的临床资料, 对胸腔积液标本进行液基细胞学检查(LBC)和DNA-ICM, 结合患者的临床诊断、影像学检查、活组织检查和随访结果, 比较两种方法的灵敏性和特异性。结果 101例患者的胸腔积液中, 恶性胸腔积液39例, 良性胸腔积液62例。LBC和DNA-ICM诊断胸腔积液中恶性肿瘤细胞的灵敏度分别为74.7%和94.9%, 特异度分别为98.4%和83.9%;二者联合比单独LBC诊断阳性率提高[36.6%(37/101)比28.7%(29/101)]。对7例DNA-ICM阳性但LBC结果为阴性病例进行随访, 其中1例诊断为小细胞肺癌。结论 DNA-ICM可有效提高胸腔积液细胞学阳性检出率, DNA-ICM和LBC联合检测可降低细胞学漏诊率, 对恶性胸腔积液病理诊断具有重要的临床价值。  相似文献   

10.
目的 探讨薄层细胞涂片法(TP)免疫细胞化学对浆膜腔积液中腺癌细胞及反应性间皮细胞鉴别诊断的应用价值.方法 对65例浆膜腔积液行常规HE染色,其中包括胸腔积液26例,腹水33例和心包积液6例.全部采用TP免疫细胞化学检测癌胚抗原(CEA)、上皮抗原(EA)、间皮细胞抗原(MC)和钙结合蛋白(Ca1)抗原的表达.结果 42例腺癌中90.5%(38/42)CEA表达阳性,95.2%(40/42)EA表达阳性,4.8%(2/42)MC表达阳性,4.8%(2/42)Cal表达阳性.在23例反应性间皮细胞中,反应性间皮细胞CEA和EA全部呈阴性表达,91.3%(21/23)MC表达阳性,87.0%(20/23)Cal表达阳性.CEA和EA在腺癌细胞中特异性为100.0%.MC和Cal在良性反应性间皮细胞中特异性为95.2%.结论 通过TP免疫细胞化学方法,选择性的联合使用4种抗体(CEA、EA、MC、Cal)可以帮助对浆膜腔积液中腺癌细胞与反应性间皮细胞的鉴别诊断.  相似文献   

11.
BACKGROUND: The diagnosis of malignant mesothelioma (MM) in serous effusions is difficult but may be achieved by the application of adjuvant methods. METHODS: The authors cytologically diagnosed 33 effusions as suspicious or positive for MM cells by using DNA-image cytometry (DNA-ICM), immunocytochemistry and AgNOR analysis. The authors further detected 9p21 deletions by chromosomal fluorescence in situ hybridization (FISH). In addition, 31 cases of metastatic carcinomas and 39 of tumor cell-negative effusions were investigated. All diagnoses were confirmed by histologic and/or clinical follow-up. RESULTS: DNA aneuploidy was found in 71% of MMs, 100% of metastatic carcinomas, and in none of the negative effusions. Calretinin was positive in 100% of MMs, in none of the metastatic carcinomas, and in 94.9% of negative effusions. BerEP4 showed positivity in 15.6% of MMs, 87.1% of metastatic carcinomas, and in none of the negative effusions. With AgNOR analysis, 89.3% of MMs and 96.7% of metastatic carcinomas showed >or=2.5 AgNOR dots as satellites and >or=4.5 as total AgNOR counts. 9p21 deletions were demonstrated in 90.9% of MM cases, 45.2% of metastatic carcinomas, and in none of the negative effusions. By cytology alone, 81.8% of MMs were identified unequivocally. Addition of DNA-ICM improved the prevalence of tumor cell detection to 87.9% and of AgNOR analysis to 97%. The introduction of 9p21 deletions by FISH improved this prevalence to 100%. CONCLUSIONS: Because of these results, the authors propose the sequential application of immunocytochemistry, DNA-ICM, and AgNOR analysis to establish a cytological diagnosis of malignant mesothelioma in serous effusions. In persistent doubtful diagnoses, the authors recommend fluorescence in situ hybridization to analyze the 9p21 deletion.  相似文献   

12.
Objective: Immunocytochemistry (ICC) of serous effusion is an important tool for the diagnosis of benign andmalignant cells. Our aim was to develop a modified liquid-based cytological technique for ICC (i.e., a modified LBC).Methods: Serous effusions of 110 cases were collected for cytological examination: 50 were negative for malignancyalbeit benign mesothelium was found, and 60 were confirmed metastatic adenocarcinoma according to the modified LBCpreparation. The latter were stained for EMA, Ber-EP4, Calretinin, and p63 then interpreted by both a cytotechnologistand a pathologist. A comparative analysis of the diagnostic results was conducted. Results: The results of the metastaticadenocarcinoma were 100% (60/60) positive for EMA and 91.7% (55/60) positive for Ber-Ep4 but negative for calretininand p63. Cases negative for malignancy were 100% (50/50) positive for calretinin but negative for carcinoma markers.The difference between ‘positive for metastatic adenocarcinoma’ and ‘negative for malignancy’ in ICC was statisticallysignificant (p < 0.001). Conclusion: The current study demonstrated that a panel marker, comprising EMA, Ber-EP4,and calretinin can be used for differentiating between cases of metastatic adenocarcinoma and benign mesothelium.The serous effusion specimen collected by the modified LBC technique is an effective preparation method for ICC.  相似文献   

13.
目的评价E-cadherin抗体辨认体腔积液内癌细胞的价值.方法采用石蜡细胞块技术对62例恶性体腔积液标本和22例间皮增生的体腔积液标本进行免疫细胞化学检测E-cadherin、BerEP4、CEA、Calretinin和Desmin,并计算各抗体辨认癌细胞或间皮细胞的敏感性和特异性.62例恶性体腔积液标本中癌性积液53例(包括肺非小细胞癌29例,肺小细胞癌2例,乳腺癌5例,胃癌4例,大肠癌3例,肝癌1例,食道癌3例,胰腺癌1例,卵巢癌4例,子宫颈癌1例),非癌性积液4例(包括淋巴瘤2例,骨髓瘤1例和恶黑1例),不明组织来源5例.结果62例恶性体腔积液标本E-cadherin的阳性率为85.5%(53/62).去除不明组织来源和非癌性积液病例后,53例癌性积液的E-cadherin阳性率为88.7%(47/53),其中乳腺、食道、大肠和卵巢等部位来源的癌性积液的阳性率均为100%.而间皮细胞E-cadherin反应均为阴性.E-cadherin、BerEP4和CEA检测癌细胞的敏感性分别为88.7%、79.2%和67.9%,E-cadherin、BerEP4和CEA检测癌细胞的特异性分别为96.2%、100%和92.3%.Calretinin和Desmin检测间皮细胞的敏感性100%和91%,特异性分别为94.7%和100%.结论本组研究结果表明E-cadherin是一个体腔积液内癌细胞的敏感和特异的标记,可以作为免疫细胞化学鉴别良恶性体腔积液的抗体组合成员之一.  相似文献   

14.
BACKGROUND: The distinction between pleural mesothelioma (MS), reactive mesothelium (RM), and adenocarcinoma (AC) in serous effusions continues as a diagnostic problem in pathology. Immunohistochemistry can help, especially in surgical samples, but the optimum panel of antibodies has yet to be reported. The application of these antibodies to serous effusions has displayed variable results. The aim of this study was to evaluate the usefulness of eight monoclonal antibodies in the differential diagnosis of MS, RM, and AC in serous effusions. METHODS: A total of 44 cytologic specimens of serous effusions (26 pleural, 15 peritoneal, and 3 pericardial) from 30 ACs, 3 MSs, and 11 RMs, previously stained with Papanicolaou stain, were selected retrospectively from our files and stained with HBME-1, thrombomodulin, calretinin, MOC-31, Ber-EP4, E-cadherin, CEA, and CD-15. The immunoreactions were evaluated independently by two pathologists. A stepwise logistic regression analysis was applied to the data to select an appropriate panel of antibodies. RESULTS: Statistical significance was found with HBME-1, thrombomodulin, MOC-31, Ber-EP4, and CD-15, when comparing both AC versus MS, and AC versus any type of mesothelial proliferation (MS or RM). Using HBME-1, 80% of ACs were negative whereas all three MSs reacted strongly with P = 0.003. A P = 0.02 was reached with thrombomodulin with 76.5% of ACs showing no immunoreactivity. Ber-EP4 and MOC-31 displayed good results with a P < 0.001 and 0.01, respectively. CD-15 reached a P = 0.034. No differences were found using the other antibodies. Ten ACs, all 3 MSs, and 10 RMs were double immunostained with HBME-1 and/or MOC-31 and Ber-EP4 successfully. CONCLUSIONS: Immunohistochemical studies performed on Papanicolaou stained cytologic smears proved to be useful in the differentiation between metastatic AC and mesothelial proliferation. HBME-1, thrombomodulin, MOC-31, Ber-EP4, and CD-15 were the most useful. In selected cases, it appeared that double immunostaining aided the differential diagnosis. Cancer (Cancer Cytopathol) Copyright 2001 American Cancer Society.  相似文献   

15.
A monoclonal antibody (MAb), designated B72.3, has been generated using membrane-enriched fractions of a metastatic human breast carcinoma as the immunogen. Previous studies have demonstrated that the reactive antigen, a novel Mr 220,000 to 400,000 glycoprotein complex, can be detected in formalin-fixed, paraffin-embedded tissue sections of human breast and colon carcinomas, and not in a variety of normal adult human tissues. In this preliminary study, we report that MAb B72.3 may be used as an adjunct for diagnosis of adenocarcinoma in cytological preparations of human effusions. Using the avidin-biotin complex method of immunoperoxidase staining and formalin-fixed, paraffin-embedded cell suspensions, MAb B72.3 detected adenocarcinoma cells in effusions from all of 21 patients with adenocarcinoma of the breast. No reactivity was demonstrated in any cell type in benign effusions from 24 patients without cancer, or 13 patients with prior or extant cancer in other body sites; moreover, B72.3 showed no reactivity to leukemic or lymphomatous effusions, or apparent mesothelial cells from malignant effusions. MAb B72.3 also detected adenocarcinoma cells in cytological effusion specimens from 12 of 12 patients with adenocarcinoma of the lung and 16 of 16 patients with adenocarcinoma of the ovary. Thus, these data suggest that the immunocytochemical application of MAb B72.3 should now be considered as an adjunct in the discrimination of adenocarcinoma cells from reactive mesothelial cells in the cytological diagnosis of malignant effusions.  相似文献   

16.
P Shaw  R Buckman  J Law  R Baumal  A Marks 《Tumour biology》1988,9(2-3):101-109
A panel of 13 mouse monoclonal antibodies (mAb) and 1 rabbit polyclonal antibody was tested for reactivity with tumor cells in 26 effusions obtained from patients with carcinoma of ovary, breast, or mesothelioma, using an immunoperoxidase staining reaction. Specific staining of tumor cells but not reactive mesothelial cells was demonstrated with some of the mAb in the panel. In 4 of 26 effusions no evidence of malignancy was obtained after routine cytological staining, but this was reversed on the basis of immunoperoxidase staining of tumor cells with the mAb in the panel. Serial effusions were evaluated in 4 patients during the course of chemotherapy, allowing an assessment of effect of therapy on the antigenic characteristics of the tumor cells. In another 4 patients, the results of immunoperoxidase staining of effusions were compared with those obtained by applying the same antibody panel to solid tumor nodules. There was a tendency to develop changes in the pattern of reactivity during therapy, and the pattern of reactivity was more restricted in tumor nodules than in effusions. One of the mAb in our panel (2G3) was consistently shown to produce strong staining of a high proportion of tumor cells in effusions and tumor nodules from patients with ovarian or breast cancer and may be of value in immunocytochemical diagnosis and therapy of epithelial malignancies.  相似文献   

17.
Applications of Immunocytochemistry to Clinical Cytology   总被引:1,自引:0,他引:1  
This article reviews the recent studies reporting the applications of immunocytochemistry to diagnostic problems in clinical cytology. A series of studies with monoclonal antibody (MAb) B72.3 is discussed in detail. MA6 B72.3, reactive with a high molecular weight, glycoprotein, tumor-Associated antigen, designated TAG-72, has been shown previously to be reactive with formalin-fixed, parafin-embedded tissue sections of adenocarcinomas of the ovary, colon, and breast, but not a variety of normal adult tissues. It has demonstrated utility as an immunocytochemical adjunct to diagnose carcinoma in cell block and cytocentrifuge preparations of human serous effusions, with selective reactivity for tumor cells (particularly adenocarcinomu) over reactive mesothelium. Using the avidin-biotin complex (ABC) method of immuno-peroxidase staining and formalin-fixed, paraffin-embedded cell suspensions, MAb B72.3 detected tumor cells in effusions from the majority of patients with adenocarcinoma of the breast. No reactivity was demonstrated in any cell type in benign effisions. In conrrast, MAb 872.3 showed no reactivity to leukemic or lymphomutous effusions, or to mesothelial cells from malignant effusions. MAb B72.3 also detected tumor cells in emion specimens from most of the patients with “non-small cell” carcinoma of the lung and with carcinoma of the ovary. MA6 B72.3 was also used with fine-needle aspiration biopsies (FNABs) and corresponding surgically excised tumors to determine cellular reactivity. Positive staining with MA6 B72.3 was observed in needle aspirates of the great majority of “non-small cell” carcinomas of the lung, adenocarcinomas of the breast, adenocarcinomas of the colon, and carcinomas from other body sites. In contrast, small cell carcinomas of the lung, malignant melanomas, lymphomas, sarcomas, and glial tumors stained negatively with the antibody. Most benign lesions from the breast, lung, pancreas, parotid, and thyroid also showed no staining. In many patients, tumor-bearing tissue had also been resected and was available for comparative examination with MAb 8723. In more than 90% of these patients, the staining patterns of tumor cells in the aspirates were found to be predictive of the patterns of antibody reactivity in the comparable surgically resected tumors. From these studies it is concluded that MAb B72.3 defines a tumor-Associated antigen that is expressed in neoplastic cells versus benign cells, is most selectively expressed in carcinomas, and may be used as a novel adjunct for the diagnosis of neoplasms in effusions and in FNABs.  相似文献   

18.
Calretinin、CEA标记在胸腹腔积液细胞学诊断中的应用   总被引:4,自引:0,他引:4  
目的:探讨calretinin、CEA免疫细胞化学标记对浆膜腔积液中正常、反应性间皮细胞与转移性癌细胞的鉴别诊断价值。方法:59例胸腹腔积液标本,采用常规:HE染色、CEA及calretinin免疫细胞化学标记。最后诊断通过活检、随访等确立。结果:最后诊断转移癌17例、良性者37例、未确定5例。Calretinin对间皮细胞标记的阳性率为94.6%(35/37)[86.5%(32/37),强阳性],转移癌细胞23.5%(4/17)阳性[5.9%(1/17)强阳性];CEA对转移癌细胞标记的阳性率为88.4%(15/17)[52.9%(9/17)强阳性],良性间皮细胞43.2%(16/37)阳性[13.5%(5/17)强阳性]。17例转移癌中,11例calretinin、CEA两项标记支持转移癌诊断;良性组中,CEA标记有较多假阳性。结论:CEA的特异性相对较差,calretinin对间皮细胞标记的特异性、敏感性较高。结果判定时,强阳性结果较弱阳性结果有意义,calretinin结果较CEA更有价值。认真细致的形态学观察,辅以calretinin及CEA标记,可有效地避免假阳性诊断。  相似文献   

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