CAJ | 학술논문

目的探讨相关蛋白标记物辅助液基薄层细胞检测(TCT)纤维支气管镜刷片细胞学肺癌分型诊断的价值.方法收集纤维支气管镜刷片细胞学临床诊断剩余标本206例,术后肺肿瘤穿刺标本45例,应用TCT制片技术和免疫细胞化学(ICC)法检测相关蛋白CK10/13、CK7、CK18、CD56和突触素(SYN)在各型肺癌中的表达.结果 CK10/13诊断鳞癌的敏感性和特异性分别为94.7%和72.0%;CK7诊断腺癌的敏感性和特异性分别为98.6%和61.5%;CK18诊断腺癌的敏感性和特异性分别为98.6%和37.5%;CD56诊断小细胞肺癌的敏感性和特异性分别为86.3%和82.9%;SYN诊断小细胞肺癌的敏感性和特异性分别为81.6%和93.5%.CK10/13、CK7和CK18在不同分化鳞癌和腺癌中的表达差异均无统计学意义(均P＞0.05).细胞形态学与ICC联合诊断细胞学未分类癌44例,其中鳞癌、腺癌和小细胞肺癌的分型诊断率分别为90.0%、96.3%和100.O%.结论相关蛋白ICC检测与细胞学相结合,可提高肺癌分型诊断的准确性,可能成为TCT纤维支气管镜刷片细胞学肺癌分型诊断的一种辅助手段.
목적 탐토상관단백표기물보조액기박층세포검측(TCT)섬유지기관경쇄편세포학폐암분형진단적개치.방법 수집섬유지기관경쇄편세포학림상진단잉여표본206례,술후폐종류천자표본45례,응용TCT제편기술화면역세포화학(ICC)법검측상관단백CK10/13、CK7、CK18、CD56화돌촉소(SYN)재각형폐암중적표체.결과 CK10/13진단린암적민감성화특이성분별위94.7%화72.0%;CK7진단선암적민감성화특이성분별위98.6%화61.5%;CK18진단선암적민감성화특이성분별위98.6%화37.5%;CD56진단소세포폐암적민감성화특이성분별위86.3%화82.9%;SYN진단소세포폐암적민감성화특이성분별위81.6%화93.5%.CK10/13、CK7화CK18재불동분화린암화선암중적표체차이균무통계학의의(균P＞0.05).세포형태학여ICC연합진단세포학미분유암44례,기중린암、선암화소세포폐암적분형진단솔분별위90.0%、96.3%화100.O%.결론 상관단백ICC검측여세포학상결합,가제고폐암분형진단적준학성,가능성위TCT섬유지기관경쇄편세포학폐암분형진단적일충보조수단.
Objective To evaluate the value of application of cellular protein markers stained by immunocytochemistry iu combination with ThinPrep bronchial brush cytology in classification of lung cancer subtypes.Methods Remaining bronchial brush cytology samples from 206 lung cancer patients with positive cytological diagnosis and 45 fine needle aspiration samples of resected lung carcinomas were collected.The expressions of CK10/13,CK7,CK18.CD56 and SYN in those samples were detected by immunocytochemistry(ICC)using corresponding antibodies.Results The sensitivity and specificity of CK10/13 were 94.7%and 72.0%.respectively,in diagnosis of squamous cell carcinoma.The sensitivity and specificity of CK7 were 98.6%and 61.5%.and those of CK18 were 98.6%and 37.5%,respectively,in diagnosis of adenocarcinoma.The sensitivity and specificity of CD56 were 86.3%and 82.9%.and those of SYN were 81.6%and 93.5%.respectively.in diagnosis of small cell lung cancer.No significant difference was found in the expressions of CK10/13.CK7 and CK18 protein markers among differently differentiated lung squamous cell carcinomas and adenocarcinomas(P＞0.05).The classification rate of cytology in combination with ICC in difierential diagnosis for 44 cases of unclassified lung cancer reached 90.0%for squamous cell carcinoma.96.3%for adenocarcinoma.and 100.0%for small cell lung carcinoma.Conclusion Application of cellular protein markers in combination with ThinPrep bronchial brush cytology is helpful to improve the differential diagnosis of lung cancer subtypes,and may become a supplementary diagnostic method in subclassification of lung cancer.