Claudin-4 和 EZH2 免疫组织化学在胸水中的诊断价值。
Diagnostic Value of Claudin-4 and EZH2 Immunohistochemistry in Effusion Cytology.
机构信息
Department of Pathology, Faculty of Medicine, Assiut University, Asyut, Egypt.
Department of Chest Diseases, Faculty of Medicine, Assiut University, Asyut, Egypt.
出版信息
Asian Pac J Cancer Prev. 2022 Aug 1;23(8):2779-2785. doi: 10.31557/APJCP.2022.23.8.2779.
BACKGROUND
Metastatic adenocarcinoma (MAC) accounts for most cases of malignant effusions. Sometimes, it can be difficult to distinguish MAC from reactive mesothelial cells (RMC) in cytologic specimens. Our aim was to assess the diagnostic performance of a novel immunohistochemical panel composed of claudin-4 and EZH2 in differentiating MAC from RMC in effusion cytology.
METHODS
A total of 80 cases of serous effusions (48 MAC and 32 RMC) were included. Immunohistochemistry using claudin-4 and EZH2 was performed on cell block sections of these cases. Assessment of staining patterns, intensity and percentage of target cells stained was done.
RESULTS
Claudin-4 showed membranous staining in 46/48 of MAC and 1/32 of RMC. High EZH2 (≥ 50% of target cells) was detected in 42/48 MAC and 2/32 RMC. For the discrimination between MAC and RMC, claudin-4 exhibited 95.8% sensitivity and 96.9% specificity, high-EZH2 exhibited 87.5% sensitivity and 93.8% specificity, while the combination of both claudin-4 and high EZH2 showed 100% sensitivity and 90.6% specificity.
CONCLUSION
Claudin-4 shows high sensitivity and specificity in differentiation between MAC and RMC in effusion cytology, and might be useful as a solitary marker for MAC. Adding EZH2 to claudin-4 increases the sensitivity to 100%. However, the interpretation of EZH2 results can be challenging due to its focal expression in RMC and inflammatory cells.
背景
转移性腺癌（MAC）占恶性胸腔积液的大多数病例。在细胞学标本中，有时很难将 MAC 与反应性间皮细胞（RMC）区分开来。我们的目的是评估一种由 claudin-4 和 EZH2 组成的新型免疫组织化学组合在区分胸腔积液细胞学中 MAC 和 RMC 方面的诊断性能。
方法
共纳入 80 例浆膜腔积液（48 例 MAC 和 32 例 RMC）。对这些病例的细胞块切片进行 claudin-4 和 EZH2 的免疫组织化学染色。评估染色模式、强度和目标细胞染色的百分比。
结果
Claudin-4 在 48 例 MAC 中的 46 例和 32 例 RMC 中的 1 例中显示出膜染色。在 48 例 MAC 中的 42 例和 32 例 RMC 中的 2 例中检测到高 EZH2（≥50%的目标细胞）。为了区分 MAC 和 RMC，claudin-4 显示出 95.8%的敏感性和 96.9%的特异性，高 EZH2 显示出 87.5%的敏感性和 93.8%的特异性，而 claudin-4 和高 EZH2 的组合显示出 100%的敏感性和 90.6%的特异性。
结论
Claudin-4 在胸腔积液细胞学中区分 MAC 和 RMC 具有很高的敏感性和特异性，可能作为 MAC 的单一标志物有用。将 EZH2 添加到 claudin-4 中可将敏感性提高到 100%。然而，由于 EZH2 在 RMC 和炎症细胞中的局灶性表达，其结果的解释可能具有挑战性。
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