Mremi Alex, Yahaya James Joseph, Abraham Zephania Saitabau, Mwakigonja Amos Rogers
Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
Niger Med J. 2019 Nov-Dec;60(6):279-284. doi: 10.4103/nmj.NMJ_134_19. Epub 2020 Feb 24.
Nasopharyngeal carcinoma (NPC) is a malignant epithelial neoplasm arising in the nasopharyngeal mucosa that shows light microscopic and/or ultrastructural evidence of squamous differentiation. Immunohistochemistry (IHC) can be used to reliably distinguish undifferentiated NPC from other malignant tumors, and the technique may be a necessary tool toward the arrival of a definitive diagnosis, particularly when dealing with challenging cases.
This was a cross-sectional hospital-based study which was conducted at Muhimbili National Hospital. The study involved 120 patients with NPC who were diagnosed on histopathological basis between 2009 and 2013.
The sensitivity and specificity of hematoxylin and eosin (H and E) stain in diagnosing NPC were 99% and 30.4%, respectively. The accuracy of H and E stain to diagnose NPC and lymphoma was 94.2% and 30.4%, respectively. CD45 antibody helped to confirm 16 cases which were diagnosed as NPC on H and E stain to be lymphoma. Further, AE1/AE3 antibody helped to confirm one case who was diagnosed as rhabdomyosarcoma on H and E stain to be NPC.
The sensitivity and accuracy of H and E stains to diagnose NPC were very high whereas the specificity was very low. A significant proportion of previously diagnosed NPC cases by routine H and E stains were confirmed not to be so by a minimal IHC antibody panel of pan-cytokeratin cocktail (AE1/AE3) and leukocyte common antigen (CD45). This highlights the paramount importance of a minimum IHC panel in assisting to obtain a definitive diagnosis in challenging cases of NPC.
鼻咽癌（NPC）是一种发生于鼻咽黏膜的恶性上皮性肿瘤，在光学显微镜和/或超微结构下显示有鳞状分化的证据。免疫组织化学（IHC）可用于可靠地区分未分化鼻咽癌与其他恶性肿瘤，该技术可能是实现明确诊断的必要工具，尤其是在处理具有挑战性的病例时。
这是一项在穆希姆比利国家医院进行的基于医院的横断面研究。该研究纳入了120例在2009年至2013年间经组织病理学诊断为鼻咽癌的患者。
苏木精和伊红（H&E）染色诊断鼻咽癌的敏感性和特异性分别为99%和30.4%。H&E染色诊断鼻咽癌和淋巴瘤的准确性分别为94.2%和30.4%。CD45抗体有助于确认16例在H&E染色下被诊断为鼻咽癌的病例实际上是淋巴瘤。此外，AE1/AE3抗体有助于确认1例在H&E染色下被诊断为横纹肌肉瘤的病例实际上是鼻咽癌。
H&E染色诊断鼻咽癌的敏感性和准确性非常高，而特异性非常低。相当一部分先前通过常规H&E染色诊断为鼻咽癌的病例，经泛细胞角蛋白混合物（AE1/AE3）和白细胞共同抗原（CD45）的最小免疫组织化学抗体组合证实并非如此。这凸显了最小免疫组织化学抗体组合在协助对具有挑战性的鼻咽癌病例进行明确诊断方面的至关重要性。
