液基薄片与免疫细胞化学结合鉴别恶性肿瘤细胞的类型

目的: 探讨液基薄层细胞涂片(TLC)和免疫细胞化学(ICC)结合鉴别恶性肿瘤细胞类型的意义。 方法: 利用薄层细胞涂片进行免疫细胞化学检测,观察抗体的表达,判断恶性肿瘤细胞的分型及来源。 结果: 针吸穿刺涂片标本130例进行免疫细胞化学检测,使用21种不同抗体鉴别恶性肿瘤细胞的类型。56例分化差的癌细胞需要鉴别为腺癌、鳞癌和小细胞癌,其免疫细胞化学结果43例与组织病理结果相符,符合率为76.8%;47例需要鉴别为小细胞癌或非霍奇金氏淋巴瘤(NHL),有46例与组织病理学结果相符,符合率为97.9%;27例小细胞型肿瘤鉴别其组织来源,27例均与组织病理学结果相符,符合率为100%,包括横纹肌肉瘤、NHL、血管肉瘤、恶性黑色素瘤等。20例Cytospin涂片ICC结果中19例与TLC一致;间叶肿瘤和淋巴瘤的免疫细胞化学结果容易识别;在具有癌巢的涂片,免疫细胞化学结果易产生假阳性。 结论: 针吸穿刺标本的TLC与免疫细胞化学结合鉴别恶性肿瘤细胞的类型,其结果与组织病理结果符合率高,可以辅助细胞学疑难病例的诊断,为临床治疗提供依据。

Application of Thin-layer Cytology Smears and Immunocytochemistry in Identifying the Cell Types of Malignant Tumors

Objective: To discuss the application of thinlayer cytology (TLC) smears and immunocytochemistry(ICC) in identifying the cell types of malignant tumors. Methods: ICC was performed with 21 types of antibodies in 130fine needle aspiration (FNA) specimens to identify the types of malignant tumor cells. Results: The cell types of 43 of the56 poorly differentiated carcinoma specimens identified by ICC were consistent with those identified by histopathology re-sults, providing an accuracy rate for ICC of 76.8% for these samples. The cell types of 46 of the 47 specimens suspectedas nonHodgins lymphomas(NHL) or small cell cancer identified by ICC were accordant with histopathological results. Theaccuracy rate of ICC for these samples was 97.9%. The cell types of the 27 specimens with unknown histological originwere 100% accurately identified by ICC. The results of cytospin in 19 of the 20 cases were in accordance with those ofTLC. The ICC results in mesenchymal tumors and lymphoma could be easily differentiated, while falsepositives could of-ten be seen in smears with cancer nests. Conclusion: ICC and TLC smears can be applied to identify the cell types of ma-lignant tumors, with a satisfactory accordance rate compared to histological results. Diagnosis using fine needle aspirationbiopsies can provide valuable information for clinical treatment.