免疫组化在恶性间皮瘤鉴别诊断中的应用价值

目的 对恶性间皮瘤进行免疫组化的对比性研究,以进一步评价它们在恶性间皮瘤鉴别诊断中的价值。方法 采用免疫组织化学染色(LSAB)法对22例恶性间皮瘤和20例对照组腺癌组织进行EMA、CEA、CK、vimentin、间皮细胞(M-cell)等5种单克隆抗体的标记。结果 恶性间皮瘤的阳性率分别为 M-cell 91％,CEA 9％,vimentin 73％,CK82％,EMA64％;而腺癌的阳性率为分别为M-cell5％,CEA 85％,vimentin 15％,CK100％,EMA 100％。结论 在恶性间皮瘤和腺癌的鉴别诊断中,M-cell和CEA是较理想的标记物,尤其是M-cell,CEA和vimentin三种抗体联合应用更具有价值。而在恶性间皮瘤和其他梭形细胞肿瘤的鉴别诊断中,还应联合使用CK和EMA。

Value of immunohistochemistry in differential diagnosis of malignant mesothelioma

Objective To evaluate the value of immunohistochemistry in differential diagnosis of malignant mesothelioma. Methods 22 cases of malignant mesothelioma tissues and 20 cases of adenocarcinoma as controls were stained with monoclonal antibodies of EMA, CEA, CK, vimentin and mesothelial cell(M - cell) respectively by LSAB method. Results The positive percentages of malignant mesothelioma were 91 % for M - cell, 9% for CEA, 73% for vimentin, 82% for CK and 64% for EMA respectively, and those of adenocarcinoma were 5% for M - cell, 85% for CEA , 15% for vimentin, 100% for CK and 100% for EMA respectively . Conclusion M - cell and CEA are ideal markers for the differential diagnosis between malignant mesothelioma and adenocarcinoma. Furthermore, the combination of M - cell and CEA with vimentin is more valuable. However, to differentiate between malignant mesothelioma and other spindlar cell tumor, the monoclonal antibodies of CK and EMA should be included.