Diagnostic value of pleural effusion cell block immunohistochemical examination in patients with suspected lung cancer / 新乡医学院学报

ABSTRACT

Objective To investigate the diagnostic value of pleural effusion cell block (PECB) immunohistochemical examination in patients with suspected lung cancer.Methods Eighty-six patients with suspected lung cancer and pleural effusion were selected from December 2014 to December 2016 in the First People's Hospital of Zaoyang City.Liquid based cytology (LBC) smear was used for the diagnosis of cell morphology.Immunohistochemical detection of cell blocks was carried out,including CK7,CK5/6,p53,thyroid transcription factor-1 (TTF-1),calretinin,CD56,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2 (HER-2),carcinoembryonic antigen (CEA),cancer antigen 125 (CA 125)and calretinin.Immunologic marker staining was further carried out according to the cell morphology and clinical data.Results LBC smear test showed that there were 61 cases of metastatic adenocarcinoma,11 cases of metastatic poorly differentiated carcinoma,3 cases of metastatic small cell carcinoma,2 cases of metastatic large cell carcinoma,3 cases of metastatic squamous cell carcinoma,2 cases of malignant tumor and 4 cases of suspicious malignant tumor in the 86 cases.Immunohistochemical results showed that there were 69 cases of primary lung metastases (including 61 cases of pulmonary adenocarcinoma,2 cases of lung squamous cell carcinoma,one case of lung adenosquamous carcinoma and 5 cases of small cell lung cancer),5 cases of metastatic adenocarcinoma of extrapulmonary origin (including 2 cases of breast cancer,one case of prostatic cancer,one case of ovarian cancer and one case of pancreatic cancer),3 cases of metastatic squamous cell carcinoma(including 2 cases of esophageal carcinoma and one case of cervical cancer),2 cases of metastatic adenosquamous carcinoma(including one case of adenosquamous carcinoma of cervix and one case of adenosquamous carcinoma of rectum),2 cases of metastatic large cell carcinoma,3 cases of large cell neuroendocrine carcinoma,1 case of mesothelioma,and 1 case without definite diagnosis in the 86 cases.In the 69 cases of primary lung tumor metastasis,there were 63 cases with positive expression of TTF-1 and CK7 protein,2 cases with positive expression of CK20 protein and 2 cases with positive expression of p53 protein.The expression of CK5/6,CD56 and calretinin protein was negative in the 69 cases.In the 5 cases of metastatic adenocarcinoma of extrapulmonary origin,there was 1 case of breast carcinoma with positive expression of ER,PR and HER-2 protein,1 cases of breast carcinoma with positive expression of ER and PR protein,1 cases of prostatic cancer with positive expression of CK5/6 protein,1 cases of ovarian cancer with positive expression of ER protein and 1 cases of pancreatic cancer with positive expression of CEA and CA125 protein.In the 3 cases of metastatic squamous cell carcinoma,there were 2 cases of esophageal cancer with positive expression of CEA and p53 protein and 1 case of cervical cancer with positive expression of ER protein.In the 2 metastatic adenosquamous carcinoma,there was 1 case of adenosquamous carcinoma of cervix with positive expression of PR and TTF-1 protein and 1 case of adenosquamous carcinoma of rectum with positive expression of CK7 and CEA protein.Conclusion PECB immunohistochemical examination can accurately diagnose primary focus and subtype lung cancer,and further help to determine the location of the exogenous tumor.