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目的病理组织学活检是胆管癌确诊的金标准,但在形态学上胆管癌与反应性胆管增生有时难以区分。我们探讨用免疫组化同时联合检测P53和CEA在胆管癌组织病理鉴别诊断中的辅助应用价值。方法选取胆管癌病例52例和对照组病例26例,其中肝内胆管癌48例,肝外胆管癌4例。男性31例、女性21例,年龄18~79岁。采用En Vi-sion二步法同时检测P53和CEA的表达。结果胆管癌及对照组P53表达率分别为89%、54%,然而在中等以上表达强度的统计中则胆管癌组表达率约60%,对照组则低至8%,两组具有显著统计学差异(P=0.014)。P53的表达与患者性别及标本类型无统计学差别,但在低分化肿瘤中表达强度更强(P=0.009)。胆管癌CEA表达率81%,对照组12%,中等强度以上表达则胆管癌中只有48%,对照组中未见中等以上表达强度病例(P<0.001)。双阳细胞表达率分别75%、7%,双阳细胞表达敏感性和特异性分别为70%,95%。结论同时检测P53和CEA在胆管癌的组织病理鉴别诊断中具有实用的临床价值。
Purpose Histopathological biopsy is the gold standard for the diagnosis of cholangiocarcinoma, but it is sometimes indistinguishable from morphological cholangiocarcinoma and reactive ductal hyperplasia. We explored the value of simultaneous immunohistochemistry detection of P53 and CEA in the differential diagnosis of cholangiocarcinoma histopathology. Methods 52 cases of cholangiocarcinoma and 26 cases of control group were selected, including 48 cases of intrahepatic cholangiocarcinoma and 4 cases of extrahepatic cholangiocarcinoma. 31 males and 21 females, aged 18 to 79 years. Simultaneous detection of P53 and CEA expression by En Vi-sion two-step method. Results The expression rates of P53 in cholangiocarcinoma and control group were 89% and 54%, respectively. However, in the statistics of moderate expression intensity, the expression rate of cholangiocarcinoma was about 60% and the control group was as low as 8% Differences (P = 0.014). The expression of P53 was not statistically different from the gender and type of patient, but it was stronger in poorly differentiated tumors (P = 0.009). The expression rate of CEA in cholangiocarcinoma was 81% in the control group and 12% in the control group, while it was only 48% in the cholangiocarcinoma in the medium intensity group. There was no significant expression in the control group (P <0.001). The expression rates of double positive cells were 75% and 7%, respectively. The sensitivity and specificity of double positive cells were 70% and 95% respectively. Conclusions Simultaneous detection of P53 and CEA has practical value in the differential diagnosis of cholangiocarcinoma.