免疫细胞化学染色检查协助鉴别浆膜腔积液中转移性腺癌原发部位

目的：探讨一组鉴别浆膜腔积液中转移性腺癌原发部位的抗体。方法：对31例浆膜腔积液转移性腺癌制备细胞蜡块切片作TTF-1、CA125、CK7、CK20免疫细胞化学染色,这些病例经组织学或结合临床资料证实：肺腺癌15例、卵巢腺癌10例、胃肠癌6例。结果：肺腺癌的阳性表达分别是TTF-1（73.3%）、CA125（26.7%）、CK7（73.3%）、CK20（0%）,卵巢腺癌的阳性表达分别是TTF-1（0%）、CA125（70.0%）、CK7（100.0%）、CK20（0%）,胃肠腺癌的阳性表达分别是TTF-1（0%）、CA125（16.7%）、CK7（0%）、CK20（100.0%）。TTF-1在肺腺癌的表达具有高度敏感性（73.3%）及特异性（100%）,CA125在卵巢腺癌的表达也有较高的敏感性（70.0%）,CK7（-）/CK20（＋）在胃肠腺癌的表达100%。结论：联合检测TTF-1、CA125、CK7、CK20能有效鉴别浆膜腔积液中来自肺、卵巢、胃肠道的腺癌。

The value of immunocytochemistry in the distinguishment of primary site of metastatic adenocarcinoma in effusions

Objective： To investigae a panel of immunohistochemical stains to help differentiate from the primary sites of metastatic adenocarcinoma in serous effusions.Methods： Thirty-one cases of metastatic adenocarcinoma in serous effusions were confirmed by histologic diagnoses and/or clinical,including 15 adenocarcinoma of lung,10 adenocarcinoma of ovary,6 gastrointestinal adenocarcinoma.Paraffin-embedded cell block sections were immunostained for TTF-1,CA125,CK7 and CK20.Results： The positive expression of lung adenocarcinoma were TTF-1（73.3%）,CA125（26.7%）,CK7（73.3%）,CK20（0%）;Ovarian adenocarcinoma were positive for TTF-1（0%）,CA125（70.0%）,CK7（100.0%）,CK20（0%）,gastrointestinal adenocarcinoma were positive for TTF-1（0%）,CA125（16.7%）,CK7（0%）,CK20（100.0%）.TTF-1 expression in lung adenocarcinoma with high sensitivity and specificity of 73.3%,100%,CA125 expression in ovarian adenocarcinoma had a higher sensitivity of 70.0%,the combination of CK7 negativity/CK20 positivity was seen in 100% of gastrointestinal adenocarcinoma.Conclusion： The combination of TTF-1,CA125,CK7 and CK20 stains is useful in distinguishing metastatic adenocarcinoma in serous effusions from lung,ovary and gastrointestinal.