摘要
目的:对膜式薄层液基细胞制片技术制备胸腔积液细胞在免疫细胞化学染色过程中增加脱水、透明等预处理步骤,以提高胸水细胞免疫细胞化学反应敏感性和特异性,从而弥补细胞形态学诊断的局限性。方法:50例恶性胸腔积液采用膜式薄层液基细胞制片,制片分成对照组与预处理组。对照组用95%酒精固定,预处理组用pH 7.4 PBS配制5%甲醛固定,50%、80%、95%、100%梯度酒精脱水、二甲苯透明,然后两组制片进行Vim、CEA、TTF-1、Calretinin免疫细胞化学染色。结果:胸腔积液用膜式薄层液基细胞制片的脱落细胞涂片分布均匀、重叠少。对照组显示只有部分标记物免疫细胞化学染色呈现不稳定阳性、信号弱或不能显示,预处理组免疫细胞化学染色定位清晰、准确、背景浅。Vim、CEA、TTF-1、Calretinin在对照组与预处理组敏感性分别为23.0%、78.6%(P<0.001),特异性为95.1%、91.8%(P>0.05)。结合细胞学形态及临床肿瘤既往史,检出肺腺癌36例、鳞癌3例、小细胞癌2例、间皮瘤2例、食管鳞癌1例、胃腺癌1例、结直肠癌2例、肝细胞肝癌1例、卵巢浆液性腺癌2例。结论:胸腔积液膜式薄层液基细胞制片经过脱水、透明程序后免疫细胞化学染色敏感性显著提高,应用免疫标记物Vim、CEA、TTF-1、Calretinin可以作为胸腔积液细胞学简单而有效的辅助诊断方法。
Objective:To investigate whether ethanol and xylene pretreatment improves the sensitivity and speci-ficity of immunostaining for cells from pleural fluid prepared with liquid -based thin layer cells.Methods:All 50 samples of malignant pleural fluid were made into TCT smear.These smears were divided into control group and pre-treatment group,which was immunostained with Vim,CEA,TTF-1 and Calretinin.Cells of control group were fixed in 95% ethanol,whereas that of pretreatment group was fixed in 5% formaldehyde,dehydrated in graded ethanol by 50%,80%,95%,100%,and transparent by xylene before immunocytochemistry.Results:Partial cells in control group showed weak positive or negative staining.While in pretreatment group,the ICC stain was stable,clear with ac-curate position as well as the slight background.The sensitivity of combination of Vim,CEA,TTF-1 and Calretinin in control and pretreatment group was 23.0%and 78.6%respectively(P<0.001).The specificity of control group and pretreatment group was 95.1%and 91.8%respectively(P>0.05).Combined with cell morphology and clinical his-tory,in 50 cases diognosed 36 cases as of lung adenocarcinoma,3 lung squamous carcinoma,2 small cell carcinoma,2 mesothelioma,1 metastatic esophagus squamous cell carcinoma,1 metastatic gastric adenocarcinoma,2 metastatic colorectal carcinoma,1 metastatic hepatocellular carcinoma and 2 metastatic ovarian serous carcinoma.Conclusion:The sensitivity of ICC in pleural effusion TCT smear was significantly improved by adding the procedure of dehydra-tion,transparent.The combination of immune markers Vim,CEA,TTF-1 and Calretinin can be used as a simple and effective method in helping cytological diagnosis of pleural effusion.
出处
《现代肿瘤医学》
CAS
2014年第9期2085-2088,共4页
Journal of Modern Oncology
基金
上海市奉贤区科委基金(编号:2010-0906)
