Cytologic malignancy versus benignancy: how useful are the "newer" markers in body fluid cytology?
Cytologic malignancy versus benignancy: how useful are the "newer" markers in body fluid cytology?
复制标题
细胞学恶性肿瘤与良性肿瘤：体液细胞学中的“新”标记物有多有用？
DOI：
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发表时间：
2009
影响因子：
4.6
通讯作者：
D. Coffey
中科院分区：
文献类型：
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作者：
Virganeyce Lyons;D. Mody;J. Zhai;D. Coffey
上下文
在体腔液中区分反应性渗出液、恶性间皮瘤和转移性腺癌是具有挑战性的。由于非特异性染色、局灶性染色或染色质量差，解释细胞块制备物中的免疫组织化学标记物可能很困难。我们选择了一组传统的和新的标记物来评估它们在评估积液中的效用。
目的
评价5种免疫组化标记物在鉴别诊断体腔液中反应性间皮瘤、恶性间皮瘤和转移性腺癌中的作用。
设计
共72个福尔马林固定，石蜡包埋的细胞块标本从胸膜和腹腔积液，包括5间皮瘤，48腺癌，和19良性积液进行了染色的抗体钙视黄蛋白，D2-40，XIAP，MOC-31，和WT 1。
结果
所有良性积液和间皮瘤均表现为D2-40弥漫性膜染色。所有间皮瘤显示钙视网膜蛋白阳性，而只有58%的良性积液染色局灶性钙视网膜蛋白。MOC-31在所有腺癌病例中均为阳性，而所有良性积液和间皮瘤均为阴性。所有转移性腺癌病例均为钙视网膜蛋白和D2-40阴性。然而，背景反应性间皮瘤细胞呈阳性钙视网膜蛋白和D2-40。总体而言，D2-40突出显示了比钙视网膜蛋白更多的间皮细胞。WT 1在50%的良性积液、60%的间皮瘤和27%的腺癌中呈阳性。XIAP染色大多数间皮瘤（80%），一些腺癌（51%），和罕见的良性积液（11%）。
结论
MOC-31和D2-40分别是上皮细胞和间皮细胞的非常敏感和特异的标志物。与calretinin相比，D2-40是间皮细胞更敏感的标记物。WT 1为非特异性。XIAP不是一个敏感的恶性肿瘤标志物，在细胞学上的价值有限。我们建议使用包括MOC-31和D2-40的面板，以提高体腔积液的诊断准确性。
CONTEXT
Differentiating reactive effusion, malignant mesothelioma, and metastatic adenocarcinoma in body cavity fluids can be challenging. Interpreting immunohistochemical markers in cell block preparations can be difficult because of nonspecific staining, focal staining, or poor staining quality. We selected a panel of conventional and newer markers to assess their utility in evaluating effusions.
OBJECTIVE
To evaluate the efficacy of 5 immunohistochemical markers in the differential diagnosis of reactive mesothelial proliferation, malignant mesothelioma, and metastatic adenocarcinoma in body cavity fluids.
DESIGN
A total of 72 formalin-fixed, paraffin-embedded cell block specimens from pleural and peritoneal effusions, including 5 mesotheliomas, 48 adenocarcinomas, and 19 benign effusions were stained with antibodies against calretinin, D2-40, XIAP, MOC-31, and WT1.
RESULTS
All benign effusions and mesotheliomas demonstrated diffuse membranous staining with D2-40. All mesotheliomas displayed calretinin positivity, whereas only 58% of benign effusions stained focally with calretinin. MOC-31 was positive in all cases of adenocarcinoma, whereas all benign effusions and mesotheliomas were negative. All cases of the metastatic adenocarcinoma were negative for calretinin and D2-40. However, background reactive mesothelial cells were positive for calretinin and D2-40. Overall, D2-40 highlighted more mesothelial cells than calretinin. WT1 was positive in 50% of benign effusions, 60% of mesotheliomas, and 27% of adenocarcinomas. XIAP stained most mesotheliomas (80%), some adenocarcinomas (51%), and rare benign effusions (11%).
CONCLUSIONS
MOC-31 and D2-40 were very sensitive and specific markers of epithelial and mesothelial cells, respectively. Compared with calretinin, D2-40 was a more sensitive marker of mesothelial cells. WT1 proved to be nonspecific. XIAP was not a sensitive marker for malignancy and had a limited value in cytology. We recommend using a panel to include MOC-31 and D2-40 to improve diagnostic accuracy in body cavity effusions.