MUC1和MUC4在鉴别积液细胞块中转移性腺癌细胞与反应性间皮细胞方面的诊断价值

Diagnostic usefulness of MUC1 and MUC4 for distinguishing between metastatic adenocarcinoma cells and reactive mesothelial cells in effusion cell blocks.

作者信息

Cho Jin Seong, Kim Ga-Eon, Lee Ji Shin, Lee Jae Hyuk, Nam Jong Hee, Choi Chan

机构信息

Department of Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea.

出版信息

Acta Cytol. 2013;57(4):377-83. doi: 10.1159/000348499. Epub 2013 Jul 12.

DOI:10.1159/000348499

PMID:23860190

Abstract

OBJECTIVE

The aim of our study was to determine the diagnostic value of MUC1 and MUC4 for distinguishing between metastatic adenocarcinoma cells (MAC) and reactive mesothelial cells (RMC) in effusion fluids.

STUDY DESIGN

A total of 237 cell block specimens from pleural and peritoneal effusions, including 196 malignant effusions with MAC and 41 benign effusions with RMC, were stained with antibodies against MUC1 and MUC4. Membranous staining with or without cytoplasmic staining was considered to be positive.

RESULTS

MUC1 immunoreactivity was observed in 194 (99.0%) of 196 cases of MAC and in 20 (48.8%) of 41 cases of RMC. MUC4 immunoreactivity was observed in 174 (88.8%) of 196 cases of MAC and in 4 (9.8%) of 41 cases of RMC. For distinguishing MAC from RMC, the MUC1 reactivity was found to be 99.0% sensitive and 51.2% specific with a positive predictive value of 90.7% and a negative predictive value of 91.3%. The sensitivity of MUC4 for MAC was 88.8%, the specificity was 90.2%, the negative predictive value was 62.7%, and the positive predictive value was 97.8%.

CONCLUSION

Our data suggest that MUC4 appears to be a sensitive and specific marker for differentiating between MAC and RMC.

摘要

目的

我们研究的目的是确定MUC1和MUC4在鉴别积液中转移性腺癌细胞（MAC）和反应性间皮细胞（RMC）方面的诊断价值。

研究设计

对237份来自胸腔和腹腔积液的细胞块标本进行检测，其中包括196份含有MAC的恶性积液和41份含有RMC的良性积液，用抗MUC1和MUC4抗体进行染色。膜染色无论有无胞质染色均视为阳性。

结果

196例MAC中有194例（99.0%）观察到MUC1免疫反应性，41例RMC中有20例（48.8%）观察到MUC1免疫反应性。196例MAC中有174例（88.8%）观察到MUC4免疫反应性，41例RMC中有4例（9.8%）观察到MUC4免疫反应性。对于鉴别MAC和RMC，发现MUC1反应性的敏感性为99.0%，特异性为51.2%，阳性预测值为90.7%，阴性预测值为91.3%。MUC4对MAC的敏感性为88.8%，特异性为90.2%，阴性预测值为62.7%，阳性预测值为97.8%。