免疫组化在肺肿瘤穿刺活检诊断中的应用

目的探讨免疫组化标记在CT引导下肺肿瘤穿刺活检病理诊断中的应用及意义。方法收集海军总医院病理科近2年来的肺穿刺标本,对进行过免疫组化标记的广谱细胞角蛋白（CKPAN）、细胞角蛋白7（CK7）、p63蛋白（p6）、表面活性蛋白B（SP-B）、甲状腺转录因子-1（TTF-1）、CD56蛋白（CD56）、突触素（Syn）、嗜铬颗粒A（CgA）及白细胞共同抗原（LCA）的病例表达情况进行分析及对比。结果 111例进行了免疫组化标记的肿瘤性病变中,结合组织病理学形态,最终诊断支持肺原发性恶性肿瘤的共有99例（鳞癌20例、腺癌65例、小细胞癌12例、特殊类型2例）,3例为转移性肿瘤,良性肿瘤2例,确定为恶性肿瘤但无法分型的7例。结论肺鳞癌表达p63,腺癌多表达CK7和TTF-1,小细胞癌常表达CD56、Syn和TTF-1。免疫组化联合应用能够有效辅助常规病理检查下对肺穿刺肿瘤的诊断及鉴别诊断。

Diagnostic significance of immunohistochemisty in the CT-guided needle biopsy of the lung tumours

Objective To explore and investigate the diagnostic value of immunohistochemical stain in the specimens of the CT-guided needle biopsy of the lung tumours. Methods All the specimens of the needle biopsy of the lung were collected from the archive of the Department of pathology in Naval General Hospital during the last 2 years,to assess the express rates of the tumours specimens which were stained for CK-PAN,CK7,p63,SP-B,TTF-1,Syn,CgA and LCA. Results There were 111 cases were immunohistochenmically stained,99 cases were diagnosed as the malignant tumours which were origined from lung,including 20 cases of squamous cell carcinoma,65 cases of adenocarcinoma,12 cases of small cell carinoma and 2 cases of special type.We also demonstrated 3 cases of metastatic tumours,2 cases of benign tumours and 7 cases of malignant tumours which were unable to give the proper type. Conclusion Squamous cell carcinoma always expresses p63.Adenocarcinoma usually expresses CK7 and TTF-1.Small cell carcinoma frequently expresses CD56,Syn and TTF-1.Immunohistochemistry may be very helpful in the diagnosis and differential diagnosis of the lung tumours of CT-guided needle biopsy,when combined with CK-PAN,CK7,P63,SP-B,TTF-1,Syn,CgA and LCA.