D2-40在转移性癌及间皮细胞浆膜腔积液中的表达

背景与目的：浆膜腔积液中癌细胞与反应性间皮细胞有时从细胞形态上难以鉴别。本文旨在观察D2-40在浆膜腔积液间皮细胞及转移性癌细胞中的表达,评价其用于鉴别诊断的价值。方法：用细胞块技术对99例浆膜腔积液标本进行免疫组化检测,观察D2-40的表达情况。99例标本中包括肺癌62例,乳腺癌4例,胃癌7例,卵巢癌9例,恶性间皮瘤1例,间皮反应性增生4例以及其他来源的转移性癌12例。反应性间皮细胞也存在于恶性浆膜腔积液中（88/95）,同时作为自身对照进行分析。结果：D2-40标记间皮细胞的敏感度为46.2%,特异度为89.4%。转移性癌标本中约33%的卵巢癌,4%的肺癌,14%的胃癌及20%的其他转移性癌呈D2-40阳性表达。结论：D2-40标记间皮细胞的特异度高,敏感度较低,可试用于原发灶不是卵巢癌的浆膜腔积液癌细胞与间皮细胞的辅助鉴别,其应用的可行性有待更大样本的观察。

The expression of D2-40 in carcinoma and mesothelial cells in body cavity effusions

Background and purpose: The cancer cells in effusions are morphologically difficult to be distinguished from mesothelial cells.This article was designed to evaluate the value of D2-40 in identifying the mesothelial cells in body cavity effusions.Methods:99 effusion specimens(62 with lung carcinoma,4 with breast carcinoma,7 with gastric carcinoma,9 with ovarian carcinoma,1 with malignant mesothelioma,4 with reactive specimens,and 12 with tumors of other origin) were assessed.Expression in reactive mesothelial cells was additionally assessed in malignant effusions(88/95).Immunohistochemical analysis using the EnVision system was performed.Results:D2-40 was expressed in less than 50% of reactive mesothelial cells.The sensitivity and specificity of D2-40 were 46.2 % and 89.4% respectively.D2-40 positive membranous staining was observed in 33% of ovarian carcinomas,4% of lung carcinomas,14% of gastric carcinomas,and 20% carcinomas of other origin.Conclusions:The results from the present study suggest high specificity and low sensitivity for D2-40 as a mesothelial marker.D2-40 may be of value in specimens in which the primary tumor is of nonovarian origin although its use should be further observed.