CAJ | 학술논문

目的比较中日专家对41例恶性间皮瘤的病理诊断结果,为制订间皮瘤诊断标准提供依据.方法收集浙江某医院2003至2010年诊断的41例恶性间皮瘤病例资料和组织样本,组织样本做成切片后由日本专家用免疫组化染色法检测肿瘤组织中钙网膜蛋白(calretinin)、Wilms瘤基因产物(WT1)、平足蛋白(D2-40)、细胞角蛋白(CK5/6)、广谱细胞角蛋白(AE1-AE3)、细胞角蛋白(CAM5.2)、上皮膜抗原(EMA)、癌胚抗原(CEA)、BerEP4、人类全癌上皮相关蛋白-2(MOC31)、甲状腺转录因子-1(TTF-1)、雌激素(ER)、孕激素(PgR)等的表达情况,并作出病理分型和诊断结论,对中日双方的诊断结论、病理分型、免疫组化标志物选择及读片结果等进行比较分析.结果日本专家确诊间皮瘤29例(70.7％),其中胸膜间皮瘤12例(占41.4％)、腹膜间皮瘤17例(占58.6％);确定不是间皮瘤的为10例(24.4％);资料不足的为2例(4.9％).中方专家确诊间皮瘤32例(占78.0％),其中胸膜间皮瘤8例(占25.0％),腹膜间皮瘤24例(占75.0％),确定不是间皮瘤的为1例(占2.4％),不确定的为8例(占19.5％).中日专家的诊断结论存在明显差异,双方对间皮瘤的病理分型无明显差异,双方专家在免疫标志物的选择及对同一标志物的阳性判定上也存在一定差异.结论该院病理专家间皮瘤诊断水平有待进一步提高,恶性间皮瘤的诊断应采用至少2个间皮瘤阳性标记和2个阴性标记联合使用的免疫组化染色方法.
목적 비교중일전가대41례악성간피류적병리진단결과,위제정간피류진단표준제공의거.방법 수집절강모의원2003지2010년진단적41례악성간피류병례자료화조직양본,조직양본주성절편후유일본전가용면역조화염색법검측종류조직중개망막단백(calretinin)、Wilms류기인산물(WT1)、평족단백(D2-40)、세포각단백(CK5/6)、엄보세포각단백(AE1-AE3)、세포각단백(CAM5.2)、상피막항원(EMA)、암배항원(CEA)、BerEP4、인류전암상피상관단백-2(MOC31)、갑상선전록인자-1(TTF-1)、자격소(ER)、잉격소(PgR)등적표체정황,병작출병리분형화진단결론,대중일쌍방적진단결론、병리분형、면역조화표지물선택급독편결과등진행비교분석.결과 일본전가학진간피류29례(70.7％),기중흉막간피류12례(점41.4％)、복막간피류17례(점58.6％);학정불시간피류적위10례(24.4％);자료불족적위2례(4.9％).중방전가학진간피류32례(점78.0％),기중흉막간피류8례(점25.0％),복막간피류24례(점75.0％),학정불시간피류적위1례(점2.4％),불학정적위8례(점19.5％).중일전가적진단결론존재명현차이,쌍방대간피류적병리분형무명현차이,쌍방전가재면역표지물적선택급대동일표지물적양성판정상야존재일정차이.결론 해원병리전가간피류진단수평유대진일보제고,악성간피류적진단응채용지소2개간피류양성표기화2개음성표기연합사용적면역조화염색방법.
Objective To compare the results of pathological diagnosis of 41 patients with malignant mesothelioma between Chinese and Japanese experts,and to provide a basis for the standard for diagnosis of mesothelioma.Methods The medical information and tissue samples of 41 patients with malignant mesothelioma were collected in a hospital in Zhejiang Province from 2003 to 2010.The expression levels of calretinin,Wilms' tumor suppressor gene (WT1),podoplanin (D2-40),cytokeratins (CK5/6,AE1/AE3,and CAM5.2),epithelial membrane antigen,carcinoembryonic antigen,BerEP4,MOC31,thyroid transcription factor-1,estrogen receptor,and progesterone receptor in tumor tissues were measured using immunohistochemical staining by Japanese experts,and the pathological classification and diagnosis were made.The results of diagnosis,pathological classification,immunohistochemical marker selection,and slide review were compared between Chinese and Japanese experts.Results Twenty-nine (70.7％) cases were diagnosed as mesothelioma by Japanese experts,among whom 12 (41.4％) cases were pleura mesothelioma,and 17 (58.6％) cases were peritoneal mesothelioma.Ten (24.4％) cases were confirmed without mesothelioma,and 2 (4.9％) cases were not confirmed due to insufficient information.Thirty-two (78.0％) cases were diagnosed as mesothelioma by Chinese experts,among whom 8 (25.0％) cases were pleura mesothelioma,and 24 (75.0％) cases were peritoneal mesothelioma.One (2.4％) case was confirmed without mesothelioma,and 8 (19.5％) cases were not confirmed.There were significant differences in the results of diagnosis between Chinese and Japanese experts.However,their pathological classifications of mesothelioma were similar.Significant differences in immunohistochemical marker selection and slide review were also found between Chinese and Japanese experts.Conclusion The diagnostic skills of those pathological experts in this hospital remain to be further improved for mesothelioma diagnosis.A panel of immunohistochemical markers including at least 2 mesothelioma-positive and 2 mesothelioma-negative markers are recommended for the diagnosis of malignant mesothelioma.