细胞块免疫细胞化学在确定转移腺癌原发灶中的意义

目的探讨细胞块免疫细胞化学在诊断转移腺癌原发灶中的临床价值。方法选取手术后有病理组织学结果对照，并且淋巴结穿刺后已做细胞块的肿瘤患者150例，其中肺腺癌30例、卵巢癌30例、肠癌30例、胃癌30例、乳腺癌30例。用细针穿刺淋巴结获取标本，用血浆凝血酶的方法制成细胞块，抗体组选择TTF-1、CA125、CDX2、Villin、GCDFP-15 5种抗体。结果肺腺癌的淋巴结中TTF-1阳性率达90％，卵巢癌的淋巴结中CA125阳性率达90％，肠癌的淋巴结中CDX2阳性率达93％，Villin阳性率达76％，胃癌的淋巴结中CDX2阳性率达50％，Villin阳性率达63％，乳腺癌的淋巴结中GCD—Fp-15阳性率达86％。结论用血浆凝血酶的方法做成的细胞块常规切片，再与免疫细胞化学相结合，不仅能确定肿瘤性质，组织学类型，解决了一些疑难病例，而且还能够对原发灶较小，比较隐匿，而以淋巴结转移为首发症状的肿瘤患者，提示确定原发灶，帮助临床制定合理治疗方案及判断预后。

Value of Immuocytochemistry of Cell Blocks in Find Primary Origin of Metastatic Adenocarcinoma

Objective To investigate the value of immuocytochemistry of cell blocks in find the primary origin of the metastatic adenocarcinoma.Methods A total of 150 samples were examined using immunohistochemistry with TTF-1,CA125,CDX2,Villin and GCDFP-15.30 cases of lung adenocarcinoma,30 cases of ovarian adenocarcinoma,30 cases of bowel adenocarcinoma,30 cases of gastric adenocarcinoma,and 30 cases of breast adenocarcinoma.All the specimens obtained by lymph nodes fine-needle aspiration biopsy,confirmed with the postoperative pathohistology.Results Positive express of TTF-1 were 90% in lung adenocarcinoma,those of CA125 were 90% in ovarian adenocarcinoma,those of CDX2 were 93% and 50%,and vilin were 76% and 63% in bowel adenocarcinoma and gastric adenocarcinoma respectively.Those of GCDFP-15 were 86% in breast adenocarcinoma.Conclusion Associated with FNAB cell blocks were treated with plasmase and immuocytochemistry not only can diagnose the lesions and confirm the histological types,but also can find minimally invasive carcinoma and confirm the primary origin,it's help to make rational therapy and prognosis,especially those of patients who only have a lymph node lumps than any another clinical symptom.