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不同组织来源腺癌细胞的形态学特征及抗体表达规律分析

齐长海,卢一艳,侯芳,刘芸
  

  1. 100049 北京 北京航天中心医院病理科
  • 收稿日期:2016-10-13 修回日期:2016-12-06 出版日期:2017-02-28 发布日期:2017-02-28

Morphological characteristics and antibody expression patterns of adenocarcinoma cells in different tissues by liquid based cytology

QI Changhai,LU Yiyan,HOU Fang,LIU Yun   

  1. Department of Pathology,Space Center Hospital,Beijing 100049,China
  • Received:2016-10-13 Revised:2016-12-06 Online:2017-02-28 Published:2017-02-28

摘要: 目的 探讨液基细胞学中不同组织来源腺癌细胞的形态学特征及抗体表达规律。
方法 收集2015年4月至2016年7月本院经组织学确诊为腺癌的浆膜腔积液标本90例,其中肺腺癌45例,卵巢腺癌45例,采用液基细胞学进行检测,观察不同组织来源腺癌细胞的形态学特征及糖链抗原125(CA125)、糖链抗原199(CA199)和癌胚抗原(CEA)的表达情况。结果 卵巢腺癌细胞主要以集群形式(数十至数百个)排列成圆形、椭圆形、乳头状,且常有重叠,边缘较光滑,细胞排列紧密,核浆比较高,胞浆相对较少,核仁小至中等大或明显,背景中可见砂砾体。肺腺癌细胞排列成球团状,胞浆丰富,黏液分泌旺盛,使细胞团极具立体感,核大,核仁明显。肺腺癌CA125与CA199的阳性表达率分别为33.33%(15/45)和28.89%(13/45),均低于卵巢腺癌的71.11%(32/45)和51.11%(23/45);Ⅰ~Ⅱ期肺腺癌及卵巢腺癌的CA125、CA199及CEA阳性表达率均低于Ⅲ~Ⅳ期,差异均有统计学意义(P<0.05)。结论 不同组织来源腺癌细胞的形态学特征存在一定差异,且 CA125、CA199及CEA的差异表达对于腺癌细胞来源的判断有一定价值。

Abstract: Objective To explore the morphological characteristics and antibody expression patterns of adenocarcinoma cells in different tissues by liquid based cytology. Methods From April 2015 to July 2016, 90 cases of serous cavity effusion diagnosed as adenocarcinoma by histology in our hospital were collected, including 45 ovarian adenocarcinoma samples and 45 lung adenocarcinoma samples. Liquid based cytology was used to observe the morphological features of adenocarcinoma cells from different tissue origin and the expression patterns of carbohydrate antigen 125(CA125), carbohydrate antigen 199(CA199)and carcinoembryonic antigen(CEA)were also investigated. Results As for ovarian adenocarcinoma,cells were arranged in clusters(tens to hundreds)in a round, oval, and papillary shape. There was often overlap and the edge was smooth with tightly packed cells. Caryoplasm is relatively high but the cytoplasm is relatively small. Small to medium or large nucleoli were visible with sand body in the background. Lung adenocarcinoma cells were arranged into pellets with abundant cytoplasm and strong mucus secretion. The cell mass is very three-dimensional, with large nuclei and obvious nucleoli. The positive expression rates of CA125 and CA199 in lung adenocarcinoma were 33.33%(15/45)and 28.89%(13/45), lower than 71.11%(32/45)and 51.11%(23/45)of ovarian adenocarcinoma with significant difference(P<0.05). The positive expression rates of three antigens in Ⅰ-Ⅱ stage of ovarian adenocarcinoma and lung adenocarcinoma samples were significantly lower than those of Ⅲ-Ⅳ stage(P<0.05). Conclusion There were some differences in the morphological characteristics of adenocarcinoma cells from different tissues, and different expression patterns of CA125, CA199 and CEA had some value in judging the source of adenocarcinoma cells.

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