CD68、SMA表达和弹力纤维染色在肺腺癌诊断中的作用

Discussing the Role of CD68 and SMA Expression and Elastic Fiber Staining in the Diagnosis of Lung Adenocarcinoma

摘要: 目的：探讨CD68、SMA免疫组化检测及弹力纤维染色在肺腺癌中的表达及其临床诊断意义。方法：应用免疫组织化学Elivision法检测73例肺浸润性腺癌及26例原位腺癌CD68、SMA的表达，并进行弹力纤维染色，分析在浸润性腺癌和原位腺癌中CD68、SMA蛋白的表达情况及弹力纤维的着色情况。结果：肺浸润性腺癌间质中肌纤维母细胞SMA表达显著高于原位腺癌组织(P < 0.05)。肺浸润性腺癌腺腔中巨噬细胞CD68的表达显著低于原位腺癌肺泡腔中巨噬细胞CD68的表达(P < 0.05)。弹力纤维染色可让脏层胸膜的弹力纤维层清晰呈现。结论：肺浸润性腺癌间质中肌纤维母细胞SMA表达增高，肺浸润性腺癌腺腔中巨噬细胞CD68的表达下降，可作为区分肺原位腺癌和浸润性腺癌的辅助诊断手段。弹力纤维染色可作为判读癌组织是否侵犯脏层胸膜的辅助诊断手段。

Abstract: Objective: To investigate the expression and clinical diagnostic significance of CD68, SMA immunohistochemical detection, and elastic fiber staining in lung adenocarcinoma. Methods: The expression of CD68 and SMA in 73 cases of invasive lung adenocarcinoma and 26 cases of adenocarcinoma in situ was detected using the immunohistochemical Elivision method, along with elastic fiber staining. The expression levels of CD68 and SMA proteins and the staining patterns of elastic fibers in invasive adenocarcinoma and adenocarcinoma in situ were analyzed. Results: The expression of SMA in myofibroblasts within the stroma of invasive lung adenocarcinoma was significantly higher than that in adenocarcinoma in situ tissues (P < 0.05). The expression of CD68 in macrophages within the glandular cavities of invasive lung adenocarcinoma was significantly lower than that in macrophages within the acinar cavities of adenocarcinoma in situ (P < 0.05). Elastic fiber staining clearly visualized the elastic fiber layer of the visceral pleura. Conclusion: Increased SMA expression in stromal myofibroblasts and decreased CD68 expression in macrophages within glandular cavities in invasive lung adenocarcinoma can serve as auxiliary diagnostic indicators for distinguishing between lung adenocarcinoma in situ and invasive adenocarcinoma. Elastic fiber staining can be used as an auxiliary method to determine whether cancer tissues have invaded the visceral pleura.