The Clinical Value Of Cell Block And Immunohistochemistry Staining In Diagnosis Of Pleural And Peritoneal Effusion

Objective:To explore the clini-calpathological value of cell block combined with immunohistochemistry staining in the diagnosis of benign and malignant effusion,and in the diagnosising of the histological cancer cell types and primary lesions of the malignant pleural and peritoneal effusion.Methods:A total of 211 inpatient samples with pleural and peritoneal effusion were collected from 2015 to 2017 in Tianjin Union Medicine Center.The clinical data,the results of cell block H&E staining sections and immunohistochemistry staining sections were analyzed by two experienced pathological doctors retrospectively.Among 211 cases,35 cases of pleural and peritoneal effusion were both submitted traditional cytological smear and cell block combined with immunohistochemistry staining.Analyze the clini-calpathological value of these two methods in the cytological diagnosis of pleural and peritoneal effusion.Result:1.According to the results of cell block combined with immunohistochemistry staing,102 cases were diagnosed as benign leisions,while 109 cases were malignant leisions.2.Comparision of the detection rate of malignant tumor cells between traditional cytological smear and cell block combined with immunohistochemistry staining1)The H&E staining results of cytological smear in 35 patients:11 cases were diagnosed as malignancy,18 cases were diagnosed as nuclear atypia,and 6 cases were diagnosed as benign.The detection rate of traditional cytological smear was31.4%(11/35).2)The H&E staining results of cell block combined with immunohistochemistry staining in 35 patients: 31 cases were diagnosed as malignancy,while 4 cases were diagnosed as benign.The detection rate of cell block combined with immunohistochemistry staining was 31(88.6%),which is higher than the detection rate of traditional cytological smear.There is statistically significant difference between these two methods(P<0.05).3.Classification of 109 malignant effusion cases by cell block combined with immunohistochemistry staining: 90(82.6%)cases were diagnosed as metastatic adenocarcinoma,3(2.75%)cases were diagnosed as malignant pleural mesothelionma;2(1.83%)cases were diagnosed as metastatic squamous cell carcinoma and 7(6.42%)cases were diagnosed as small cell lung carcinoma.However,there were 7(6.42%)of these 109 cases were diagnosed as malignant,but the histological cancer cell types and the primary lesion were undefinited.Among the90 cases of metastatic adenocarcinoma,52(57.8%)cases were diagnosed as metastatic lung adenocarcinoma,3(3.30%)cases were diagnosed as metastatic breast adenocarcinoma,12(13.3%)cases were diagnosed as metastatic ovarian adenocarcinoma,11(12.2%)cases were diagnosed as metastatic gastrointestinal adenocarcinoma and 2(2.20%)cases were diagnosed as metastatic pancreas.The rest10(11.1%)cases were diagnosed as metastatic adenocarcinoma,but the primary lesions were not identified.Conclusion:1.The detection rate of cell block combined with immunohistochemistry staining was higher than the traditional cytological smear(88.6% versus 31.4%).There is statistically significant difference between these two methods(P<0.05).2.Cell block combined with immunohistochemistry staining provides more objective diagnostic value for pleural and peritoneal effusion.It can not only distinguish the property of benign and malignant effusion,but also clearly diagnose the histological cancer cell types and the primary lesions of malignant effusion.3.Cell block combined with immunohistochemistry staining make great efforts to the difference of the second uncovering primary cancer sites from the original one,as well as the diagnosis of the recurrence of the previous lesion.