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背景与目的:浆膜腔积液中癌细胞与反应性间皮细胞有时从细胞形态上难以鉴别。本文旨在观察D2-40在浆膜腔积液间皮细胞及转移性癌细胞中的表达,评价其用于鉴别诊断的价值。方法:用细胞块技术对99例浆膜腔积液标本进行免疫组化检测,观察D2-40的表达情况。99例标本中包括肺癌62例,乳腺癌4例,胃癌7例,卵巢癌9例,恶性间皮瘤1例,间皮反应性增生4例以及其他来源的转移性癌12例。反应性间皮细胞也存在于恶性浆膜腔积液中(88/95),同时作为自身对照进行分析。结果:D2-40标记间皮细胞的敏感度为46.2%,特异度为89.4%。转移性癌标本中约33%的卵巢癌,4%的肺癌,14%的胃癌及20%的其他转移性癌呈D2-40阳性表达。结论:D2-40标记间皮细胞的特异度高,敏感度较低,可试用于原发灶不是卵巢癌的浆膜腔积液癌细胞与间皮细胞的辅助鉴别,其应用的可行性有待更大样本的观察。
BACKGROUND & AIM: Cancer cells and reactive mesothelial cells in serous effusions are sometimes difficult to differentiate from cell morphology. This article aims to observe the expression of D2-40 in serosal effusion mesothelial cells and metastatic cancer cells, to evaluate its value for the differential diagnosis. Methods: 99 cases of serous effusions were examined by immunohistochemistry with cell block technique to observe the expression of D2-40. Sixty-nine cases of lung cancer, four cases of breast cancer, seven cases of gastric cancer, nine cases of ovarian cancer, one case of malignant mesothelioma, four cases of mesothelioma hyperplasia, and 12 cases of metastatic carcinoma of other origins were included in 99 samples. Reactive mesothelial cells were also present in the malignant serosal effusion (88/95) and were also analyzed as a self-control. Results: The sensitivity of D2-40 labeled mesothelial cells was 46.2% and the specificity was 89.4%. Approximately 33% of ovarian cancers, 4% of lung cancers, 14% of gastric cancers and 20% of other metastatic cancers in metastatic cancer specimens were positive for D2-40. CONCLUSION: D2-40-labeled mesothelial cells have high specificity and low sensitivity, which can be used for the auxiliary identification of serous cavity cells and mesothelial cells whose primary tumor is not ovarian cancer. The feasibility of its application is still to be determined Observation of larger samples.