Clinical significance of expression of EGFR and the diagnostic value of cell wax block in malignant pleural effusions of lung adenocarcinoma / 中国基层医药

ABSTRACT

Objective To investigate the diagnostic value of cell wax block combined with immunohistochemistry in the diagnosis of malignant pleural effusion in lung adenocarcinoma and to analyze the expression and clinical significance of EGFR in pleural effusion.Methods From March 2013 to June 2017,50 lung cancer patients with pleural effusion specimens and corresponding histological specimens of lung adenocarcinoma in the Central Hospital of Wenzhou were selected.The intensity of EGFR expression in pleural effusion lung adenocarcinoma cells was detected.The difference of EGFR expression between pleural effusion cells and paraffin blocks was compared by ARMS method.Results The EGFR negative,weak positive,moderate positive and strong positive expression rates were 1 case (2.0％),8 cases(16.0％),20 cases(40.0％) and 21 cases(42.0％),respectively.There were no statistically significant differences in the sensitivity and specificity between the ARMS method and the immunohistochemical staining of lung cancer tissues (x2 =0.000,0.006,all P ＞ 0.05).The consistency of detection was excellent (Kappa value =0.93,P ＜ 0.001).There was no statistically significant differences in sensitivity and specificity between ARMS and pleural effusion wax immunohistochemical staining(x2 =0.014,0.027,all P ＞0.05),and the consistency was better (Kappa value =0.72,P ＜ 0.05).Conclusion Pleural effusion cells have the advantages of easy access,low cost,simple operation and good specificity,which is an easy and effective method to assess the expression of EGFR gene mutation in lung adenocarcinoma,which provides a reference for individualized treatment and prognosis of advanced lung adenocarcinoma.