2种免疫细胞化学染色方法在脑脊液转移性肺腺癌诊断中的应用

Application of two immunocytochemical staining methods in the diagnosis of cerebrospinal fluid metastatic lung adenocarcinoma

  • 摘要:
    目的 探讨2种免疫细胞化学染色方法在脑脊液转移性肺腺癌诊断中的应用。
    方法 收集2016年1月至2023年12月有肺腺癌病史并脑脊液转移的病例11例,行脑脊液细胞学检查;对照组为11例脑脊液转移性肺腺癌的苏木精—伊红染色或巴氏染色样本,实验组为相应对照组重制片或褪色后行免疫细胞化学染色的样本,同时分析11例病例的临床资料、细胞学形态、诊断方法及免疫细胞化学染色结果。
    结果 对照组镜下见数个异型细胞聚集成团或单个细胞散在分布,细胞胞浆中等到丰富,细胞核大、深染,部分细胞可见明显核仁,实验组做TTF-1、NapsinA免疫细胞化学染色证实为转移性肺腺癌。
    结论 肺腺癌脑膜转移患者预后极差,脑脊液细胞学的明确诊断对临床意义重大;在脑脊液标本量有限且仅有极少量异型细胞的情况下,重制片或褪色后行免疫细胞化学染色,能做出明确诊断,以辅助临床进行治疗。

     

    Abstract:
    Objective To investigate the application of two immunocytochemical staining methods in the diagnosis of cerebrospinal fluid metastatic lung adenocarcinoma.
    Methods From January 2016 to December 2023, 11 patients with a history of lung adenocarcinoma and cerebrospinal fluid metastasis were collected for cerebrospinal fluid cytology. The control group included 11 cases of metastatic lung adenocarcinoma in cerebrospinal fluid stained with hematoxylin and eosin or Papanicolaou staining, and the experimental group included the re- prepared or faded samples of the corresponding control group for immunocytochemical staining. The clinical data, cytological morphology, diagnostic methods and immunocytochemical staining results of the 11 cases were analyzed.
    Results In the control group, several atypical cells were observed in clusters or single cells scattered, with moderate to abundant cytoplasm, large and dark nuclei, and some cells had obvious nucleoli. In the experimental group, the metastatic lung adenocarcinoma was confirmed by TTF-1 and NapsinA immunocytochemical staining.
    Conclusion The prognosis of patients with leptomeningeal metastasis from lung adenocarcinoma is extremely poor. The definite diagnosis of cerebrospinal fluid cytology is of great significance for clinical practice. When the amount of cerebrospinal fluid specimens is limited and there are only a small number of atypical cells, immunocytochemical staining after re-preparing or fading can make a definite diagnosis to assist clinical treatment.

     

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