Wolber R A, Greene C A, Dupuis B A
Department of Anatomic Pathology, University of British Columbia, Vancouver, Canada.
Acta Cytol. 1991 Mar-Apr;35(2):215-20.
In order to assess the utility of immunocytochemical staining of bile canaliculi with a polyclonal antiserum to carcinoembryonic antigen (pCEA) in the differentiation of primary hepatocellular carcinomas from metastatic malignancies, pCEA staining was performed on fine needle aspiration specimens from hepatic lesions in 60 patients. The original cytologic diagnoses were hepatocellular carcinoma in 22 patients, metastatic neoplasm or cholangiocarcinoma in 27 patients and benign hepatocytes in 11 cases. The cytologic diagnoses of malignancy were confirmed by surgical excision, autopsy or clinical investigations in 82% of the patients. Follow-up data, supported by pCEA staining, reversed the original cytologic diagnosis in three cases. Bile canalicular pCEA staining was identified in 18 of 22 cases of hepatocellular carcinoma and in all 11 benign hepatocellular aspirates. All 27 cases of metastatic malignancy or cholangiocarcinoma were negative for canalicular pCEA staining, although 11 cases exhibited cytoplasmic staining. Interpretation of pCEA staining was not affected by the intermingling of malignant cells and benign hepatocytes. Predictive values were 100% for a positive test and 87% for a negative test. These findings indicate that staining with pCEA antiserum is a useful adjunct in the differential cytologic diagnosis of malignant hepatic lesions.
为了评估用癌胚抗原多克隆抗血清（pCEA）对胆小管进行免疫细胞化学染色在原发性肝细胞癌与转移性恶性肿瘤鉴别诊断中的作用，对60例肝脏病变细针穿刺标本进行了pCEA染色。最初的细胞学诊断为肝细胞癌22例，转移性肿瘤或胆管癌27例，良性肝细胞11例。82%的患者通过手术切除、尸检或临床检查证实了恶性肿瘤的细胞学诊断。在pCEA染色支持下的随访数据使3例患者的最初细胞学诊断得以逆转。22例肝细胞癌中有18例发现胆小管pCEA染色，11例良性肝细胞穿刺标本均有此染色。27例转移性恶性肿瘤或胆管癌的胆小管pCEA染色均为阴性，尽管11例有细胞质染色。pCEA染色的解读不受恶性细胞与良性肝细胞混合的影响。阳性试验的预测值为100%，阴性试验的预测值为87%。这些发现表明，pCEA抗血清染色在恶性肝脏病变的鉴别细胞学诊断中是一种有用的辅助手段。
