恶性上皮性间皮瘤免疫组化特征及其鉴别诊断

目的　探讨恶性上皮性间皮瘤 (MEM)的免疫组化特征 ,寻找MEM与转移性卵巢腺癌 (OA)和结直肠腺癌(CA)鉴别诊断的免疫组化标记物。方法　采用免疫组化SP法染色 ,观察 18例MEM、2 0例OA和 2 0例CA组织标本中HBME 1、E cadherin、CA19 9、MOC 31和CK7的表达。结果　E cadherin、CA19 9和MOC 31的表达在MEM与OA两组间差异显著 (P <0 0 5 )。HBME 1、E cadherin、CA19 9、MOC 31和CK7的表达在MEM与CA两组间差异极显著(P <0 0 1)。结论　HBME 1可作为MEM与CA鉴别的阳性标记物 ;E cadherin、CA19 9和MOC 31均可作为MEM与OA和CA鉴别的阴性标记物 ;CK7是鉴别MEM与CA最好的阳性标记物 ,但不能作为MEM与OA鉴别的指标。

Immunohistochemical features and differential diagnosis of malignant epithelial mesothelioma

Objective To investigate the immunohistochemical features of malignant epithelial mesothelioma (MEM), and to seek the valuable markers for distinguishing MEM from metastatic ovarian adenocarcinoma (OA) and colorectal adenocarcinoma(CA). Methods Immunohistochemical SP method was used to detect expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 in paraffin-embedded tissues in 18 cases of MEM, 20 OA and 20 CA. Results There was a signficant difference in the expression of E-cadherin, CA19-9 and MOC-31 between MEM and OA groups ( P <0.05). Similarly, the expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 was found valuable for distinguishing MEM from CA groups ( P <0.01). Conclusions These results indicate that HBME-1 can be used as a positive marker in distinguishing MEM from CA. E-cadherin, CA19-9 and MOC-31 are considered as negative markers useful in diagnostic distinction between MEM and metastatic adenocarcinomas (including OA and CA). CK7 is the best positive marker for distinguishing MEM from CA, but it appears to be valueless in discriminating between MEM and OA.