细胞块免疫细胞化学在乳腺癌术前辅助化疗中的意义

目的:探讨细胞块免疫细胞化学在乳腺癌术前辅助化疗中的临床价值。方法:用10ml持笔式负压穿刺器穿刺乳腺癌患者肿物,血浆凝血酶方法制做成细胞块,选择术前已做细胞块,并且术后有病理组织学对照的乳腺癌90例分别进行免疫组化标记。抗体选用ER、PR、cerbB-2、P53、VEGF、Ki67。结果:细胞块免疫细胞化学结果:阳性率分别为ER 68%、PR 63%、cerbB-2 30%、P53 34%、VEGF 57%、ki67 79%。术后病理组织免疫组化结果:ER 70%、PR 66%、cerb-2 32%、P53 37%、VEGF59%、Ki67 81%。结论:持笔式负压穿刺器穿刺乳腺癌组织,血浆凝血酶法制做的细胞块,不仅操作简便快捷、安全、不需特殊设备,而且可连续切片做多种抗体检测以满足诊断需要,其免疫细胞化学结果和术后病理免疫组织化学结果对比无明显差异。乳腺癌辅助化疗前用细胞块制备的标本检测ER、PR、cerbB-2、P53、VEGF、Ki-67,能了解乳腺癌患者内分泌情况及恶性程度和预后,为术前辅助化疗及内分泌治疗提供必要的参考指标,从而对乳腺癌患者进行针对性的个体化疗方案,增加乳腺癌患者保乳手术机会,提高患者的生存期和治愈率。

Clinical value of cell block immunocytochemistry in preoperative adjuvant chemotherapy of breast cancer

Objective:To investigate the clinical value of cell block immunocytochemistry in preoperative adjuvant chemotherapy of breast cancer.Methods:Breast cancer patients were aspirated by 10 ml of holding-pen type continuous negative pressure fine needle puncture outfit,then cell block was parepared by the method of plasma thrombin.A total of 90 cases of breast cancer with cell block obtained preoperatively and postoperative pathology for control group were detected by immunocytochemistry with antibody:ER,PR,cerbB-2,P53,VEGF and Ki67.Results:The results of immunocytochemistry for cell block with positive rates: ER 68%,PR 63%,cerbB-2 30%,P53 34%,VEGF 57% and ki67 79%.The results of immunohistochemistry for postoperative pathological tissues with positive rates: ER 70%,PR 66%,cerbB-2 32%,P53 37%,VEGF 59% and Ki67 81%.Conclusion:The method of cell block preparation is safe and quickly,easy.The cells in the block are abundant and well-distributed,and the successive sections can satisfy the clinical need.There is no difference between the results of immunocytochemistry for cell block and immunohistochemistry for postoperative pathological tissues.ER,PR,cerbB-2,P53,VEGF and Ki67 detected in the sample prepared by cell block before adjuvant chemotherapy of breast cancer are not only used to evaluate the endocrine information,malignant level and prognosis,but also to be a reference index for preoperative adjuvant chemotherapy and endocrine therapy,which can help patients carry out a plan of individual chemotherapy.