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在常规石蜡切片,部分分化不良大细胞肿瘤难以分类。为估计预后和选择恰当的治疗,区分大细胞淋巴瘤、癌、恶性黑色素瘤或肉瘤很重要。虽有报告应用免疫组化法对此类肿瘤进行区别,但尚无用抗体小组直接区分的报告。本文报告用5种抗体构成的小组对29例分化不良大细胞肿瘤分类研究,而这些肿瘤即使有经验的病理学家用常规组织学和组化法,也不能分类。抗体由5种分别为抗角蛋白、波形纤维、人乳汁脂球膜抗原MAM-6、黑色素相关抗原和白血细胞共同抗原的抗体构成,能使用常规固定、石蜡包埋的组织。应用本抗体小组的结果为95％的病例明确诊断;其余病例则得到有价值的信息,可通过辅加标记和电镜观察肯定诊断。随访和治疗结果,与抗体小组的诊断相符。
In routine paraffin sections, poorly differentiated large cell tumors are difficult to classify. It is important to distinguish large cell lymphoma, carcinoma, malignant melanoma, or sarcoma in order to estimate the prognosis and choose the appropriate treatment. Although there are reports of the use of immunohistochemistry to distinguish such tumors, there are no reports directly distinguishable by antibody groups. This paper reports on the classification of 29 cases of poorly differentiated large cell tumors using a panel of five antibodies that cannot be classified even by experienced pathologists using conventional histology and histochemistry. The antibody is composed of five antibodies that are anti-keratin, corrugated fiber, human milk lipid membrane antigen MAM-6, melanin-associated antigen, and white blood cell common antigen, and can use conventional fixed, paraffin-embedded tissues. The results of the use of this antibody group were confirmed in 95% of the cases; the rest of the cases were valuable information, which could be diagnosed by auxiliary markers and electron microscopy. Follow-up and treatment results were consistent with the diagnosis of the antibody group.