肋膜積液細胞臘塊切片分析於肺腺癌診斷之應用

肺癌是全世界癌症相關死亡的最主要原因。肺癌是指肺部組織不正常增生所形成的惡性腫瘤，主要分為小細胞肺癌及非小細胞肺癌，最常見的類型為非小細胞肺癌（NSCLC），佔全部肺癌病例的85%。在肺癌中為肺腺癌最常見約佔40%，大多起源於肺部外圍組織且與吸煙較無密切關係，並容易轉移肋膜引起胸腔積液。約10%的肺癌患者沒有明顯的臨床症狀，往往在常規胸部Ｘ光檢查時發現，在確診時的階段分類通常為晚期已經錯失開刀的時機。肺癌一般診斷的方式除了放射影像學（如電腦斷層等）的發現外，還要透過組織病理學的診斷，意即必須由痰液或肺部、支氣管或頸部淋巴結取得細胞或組織切片標本來確定，這些方法在採檢上都有各自的條件限制。本研究使用細胞病理學的方法將胸腔積液做成細胞臘塊透過免疫組織化學染色CK7、CK20及 TTF-1組合的方式，在肺腺癌符合CK7+/CK20-/TTF-1+其AUC達0.8425，表示具有良好的判別力，且更方便快速，讓臨床醫師對肺腺癌有多一種檢測方法。

關鍵字

肋膜積液；肺腺癌；細胞臘塊

並列摘要

Lung cancer is the main cause of cancer-related death worldwide, lung cancer (also known as carcinoma of the lung) is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung. The main primary types are small-cell lung cancer (SCLC), and non-small-cell lung cancer (NSCLC). The most common form is on-small cell lung cancer (NSCLC), accounting for 85 % of all cases. Nearly 40% of lung cancers are adenocarcinoma, which usually originates in peripheral lung tissue. However, among people who never-smokers in their lifetimes, adenocarcinoma is the most common form of lung cancer and Easy to transfer pleural effusion caused. About 10% of people with lung cancer do not have symptoms at diagnosis, Outcomes are generally worse in the developing world. Stage is often advanced at the time of diagnosis. These cancers are incidentally found on routine chest radiography. Lung cancer may be seen on chest radiographs and computed tomography (CT) scans. The diagnosis is confirmed by biopsy which is usually performed by bronchoscopy or CT-guidance, these methods have their own constraints on specimen collection. In this study, a method using a cytology pleural effusion cells made cell block through immunohistochemical staining CK7, CK20, and TTF-1 combination approach, In lung adenocarcinoma compliance with CK7 + / CK20-/TTF-1 + its AUC of 0.8425, represents an excellent discriminant, And more easily and quickly, Let clinicians one more method to detect lung adenocarcinoma cancer.

並列關鍵字

pleural effusion ； lung adenocarcinoma ； cell block

參考文獻

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延伸閱讀

潘雪幸、王桂芸（2004）。肺癌併發肋膜積水之病生理變化－案例分析。護理雜誌，51(2)，91-96。https://doi.org/10.6224/JN.51.2.91
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肋膜積液細胞臘塊切片分析於肺腺癌診斷之應用

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