[Value of immunocytochemistry in differential diagnosis of gastric adenocarcinoma, reactive mesothelial cells and malignant epithelial mesothelioma in metastatic effusion fluid]

Zhonghua Bing Li Xue Za Zhi. 2018 Mar 8;47(3):180-185. doi: 10.3760/cma.j.issn.0529-5807.2018.03.007.
[Article in Chinese]

Abstract

Objective: To investigate the diagnostic value of some antibodies in peritoneal fluid of patients with gastric cancer and malignant epithelioid mesothelioma in serous effusion. Methods: One hundred and eighty-two cases of serous effusion were collected at Jilin Cancer Hospital, from July 2012 to July 2016. The expression of GLUT1, CDX2, Villin, calretinin and WT1 was evaluated using SP immunocytochemical technique in peritoneal fluid samples collected from 98 patients with gastric cancer and 74 patients with reactive mesothelial cells. The expression of GLUT1, calretinin and WT1 was also evaluated in serous effusion from 10 patients with mesothelioma. Results: The sensitivity of GLUT1, CDX2 and Villin in adenocarcinoma cells was 91.8%(90/98), 68.4% (67/98) and 88.8%(87/98), respectively. The specificity was 95.9% (71/74), 100.0%(74/74) and 100.0% (74/74), respectively. The sensitivity of calretinin and WT1 for reactive mesothelium was 93.2% (69/74) and 79.7% (59/74), respectively. The specificity was 96.9% (95/98) and 100.0% (98/98), respectively. The sensitivity of GLUT1, calretinin and WT1 for mesothelioma was 9/10, 9/10 and 7/10. The reactivity of GLUT1, CDX2, Villin, calretinin and WT1 showed a significant difference (P<0.01) between adenocarcinoma cells and reactive mesothelium. The reactivity of GLUT1 showed a significant difference (P<0.01) between mesothelioma and reactive mesothelium. Conclusions: The optimal combination is a panel of GLUT1, CDX2, Villin, calretinin and WT1 for differential diagnosis between adenocarcinoma cells and reactive mesothelium in peritoneal fluid of patients with gastric cancer. Whereas GLUT1, calretinin and WT1 is the best for differential diagnosis between reactive mesothelium and mesothelioma in serous effusions.

目的:探讨细胞蜡块切片免疫细胞化学染色检测几种标志物,对胃癌患者腹水中腺癌细胞及浆膜腔积液中恶性上皮型间皮瘤细胞诊断与鉴别诊断的临床应用价值。 方法:收集吉林省肿瘤医院2012年7月至2016年7月住院患者182例,于接受任何治疗前采集的腹水。其中胃癌腹水98例,良性疾病腹水74例,恶性上皮型间皮瘤浆膜腔积液10例。应用免疫细胞化学SP法检测葡萄糖转运蛋白1(GLUT1)、尾型同源框基因2(CDX2)、绒毛蛋白(Villin)、神经特异性钙结合蛋白(calretinin,CR)和Wilms抑癌基因1(WT1)在98例胃癌患者腹水中的腺癌细胞和74例良性疾病腹水中的反应性间皮细胞的表达,以及GLUT1、CR和WT1在10例恶性上皮型间皮瘤浆膜腔积液中瘤细胞的表达。 结果: GLUT1、CDX2和Villin检测腺癌细胞的灵敏度分别为91.8%(90/98)、68.4%(67/98)和88.8%(87/98),特异度分别为95.9%(71/74)、100.0%(74/74)和100.0%(74/74);CR和WT1检测间皮细胞的灵敏度分别为93.2% (69/74)和79.7%(59/74),特异度分别为96.9%(95/98)和100.0%(98/98);GLUT1、CR和WT1在浆膜腔积液中检测恶性上皮型间皮瘤细胞的灵敏度分别为9/10、9/10和7/10;GLUT1、CDX2、Villin、CR及WT1在胃腺癌细胞和反应性间皮细胞之间的阳性率差异具有统计学意义(P<0.01),GLUT1在浆膜腔积液中恶性上皮型间皮瘤细胞和反应性间皮细胞的阳性率差异具有统计学意义(P<0.01)。 结论: GLUT1、CDX2、Villin、CR和WT1组合鉴别胃癌患者腹水中腺癌细胞和反应性间皮细胞的效果较好,GLUT1、CR和WT1组合鉴别反应性间皮细胞和恶性上皮型间皮瘤细胞的效果较好。.

Keywords: Diagnosis, differential; Immunohistochemistry; Mesothelioma; Serous effusion; Stomach neoplasms.

MeSH terms

  • Adenocarcinoma / chemistry*
  • Adenocarcinoma / diagnosis
  • Ascitic Fluid / chemistry*
  • Biomarkers, Tumor / analysis
  • CDX2 Transcription Factor / analysis
  • Calbindin 2 / analysis
  • Diagnosis, Differential
  • Epithelium / chemistry
  • Glucose Transporter Type 1 / analysis
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / chemistry*
  • Lung Neoplasms / diagnosis
  • Mesothelioma / chemistry*
  • Mesothelioma / diagnosis
  • Mesothelioma, Malignant
  • Microfilament Proteins / analysis
  • Neoplasm Proteins / analysis*
  • Sensitivity and Specificity
  • Stomach Neoplasms / chemistry*
  • Stomach Neoplasms / diagnosis
  • WT1 Proteins / analysis

Substances

  • Biomarkers, Tumor
  • CALB2 protein, human
  • CDX2 Transcription Factor
  • CDX2 protein, human
  • Calbindin 2
  • Glucose Transporter Type 1
  • Microfilament Proteins
  • Neoplasm Proteins
  • SLC2A1 protein, human
  • WT1 Proteins
  • WT1 protein, human
  • villin