免疫细胞化学与浆膜腔积液细胞学诊断

目的解决浆膜腔积液中疑难病例的确诊、分型,探讨免疫细胞化学在积液中鉴别诊断的价值,找出用于诊断的合适抗体。方法选用6种单克隆抗体:钙视网膜素(CAL)、上皮细胞膜抗原(EMA)、癌胚抗原(CEA)、细胞角蛋白17和18(CK17标记鳞癌,CK18标记腺癌)、波形蛋白(VIM),对58例积液标本进行诊断。结果在58例积液标本中,免疫细胞化学鉴别出恶性积液38例,反应性积液20例。结论CAL、EMA、CEA、VIM联合应用可从正反两方面同时证明癌细胞的存在,是积液中免疫细胞化学的较佳抗体组合。CK17、CK18对鉴别积液中鳞癌、腺癌有参考价值。在细胞学检查中应普遍推广免疫细胞化学。

The value of immunocytochemistry in the cytological diagnosis of serous effusion

Objective To investigate the value of immunocytochemistry in the differential diagnosis of difficult cases with serous effusion in the serous cavity. Methods The immunocytochemical method was utilized for the differential diagnosis and classification of malignant tumor cells in serous effusion.Epithelial membrane antigen(EMA),carcinoembryonic antigen(CEA),(CAL),(CK)17,CK18 and vimentin(VIM) were detected in 58 serous specimens. Results In 58 cases with immunocytochemical examination,there were 38 malignant cases and 20 reactive cases. Conclusions The combination use of CAL,EMA,CEA and VIM provides the best result for the identification of cancer cells from both negative and positive sides,CK17 and CK18 have some value in the differentiation of squamous cell carcinoma from adenocarcinoma in the effusion.Immunocytochemistry should be widely used in cytological diagnosis.