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目的探讨联合检测Pax8、CK7和CK20在卵巢原发性黏液肿瘤和转移性消化道黏液腺癌鉴别诊断中的意义。方法应用免疫组化SP法检测CK7、CK20和Pax8在61例卵巢原发性黏液肿瘤(交界性肿瘤52例,黏液腺癌9例)和17例转移性消化道黏液腺癌中的表达情况。结果 CK7和Pax8在卵巢原发性黏液肿瘤和转移性消化道黏液腺癌中的阳性率差异显著(P<0.01),CK20的阳性率差异不显著(P>0.05);CK7(+)/CK20(-)在卵巢原发性黏液肿瘤中的表达明显高于转移性消化道黏液腺癌(P<0.05),CK7(-)/CK20(+)在卵巢原发性黏液肿瘤中的表达明显低于转移性消化道黏液腺癌(P<0.01),CK7(+)/CK20(+)和CK7(-)/CK20(-)在这两种肿瘤中的表达差异不显著(P>0.05)。CK7(+)/CK20(-)/Pax8(+)在这两种肿瘤中的表达差异显著(P<0.05)。CK7(+)/CK20(-)检测的敏感度为0.6471,特异度为0.8361,ROC曲线下面积(AUC)为0.7941;CK7(+)/CK20(-)/Pax8(+)检测的敏感度为0.7647,特异度为0.8033,AUC为0.8664。结论联合检测CK7/CK20/Pax8可提高鉴别诊断卵巢原发性黏液肿瘤与转移性消化道黏液腺癌的敏感度及AUC,具有更高的准确性。Pax8在两种肿瘤的鉴别诊断中可作为一个重要的免疫组化补充检测指标。
Objective To investigate the significance of the combined detection of Pax8, CK7 and CK20 in the differential diagnosis of ovarian mucinous adenocarcinoma and primary mucinous neoplasm. Methods The expression of CK7, CK20 and Pax8 in 61 cases of ovarian primary mucinous tumors (52 cases of borderline tumors, 9 cases of mucinous adenocarcinoma) and 17 cases of metastatic mucosal adenocarcinoma of the digestive tract were detected by immunohistochemical SP method. Results The positive rates of CK7 and Pax8 in ovarian mucinous adenocarcinoma of the ovary and metastatic mucosa of adenocarcinoma were significantly different (P <0.01), while the positive rates of CK20 were not significantly different (P> 0.05). CK7 (+) / CK20 (-) in primary ovarian mucinous neoplasms was significantly higher than that in metastatic mucinous adenocarcinomas (P <0.05). The expression of CK7 (-) / CK20 (+) in ovarian primary mucinous neoplasms was significantly lower There was no significant difference in the expression of CK7 (+) / CK20 (+) and CK7 (-) / CK20 (-) in metastatic mucosal adenocarcinoma of the digestive tract between the two tumors (P> 0.05). The expression of CK7 (+) / CK20 (-) / Pax8 (+) was significantly different between the two tumors (P <0.05). The sensitivity of CK7 (+) / CK20 (-) was 0.6471, the specificity was 0.8361, and the area under the ROC curve was 0.7941. The sensitivity of CK7 (+) / CK20 (-) / Pax8 0.7647, specificity of 0.8033 and AUC of 0.8664. Conclusions The combined detection of CK7 / CK20 / Pax8 can improve the sensitivity and AUC of differential diagnosis of primary ovarian mucinous ovarian cancer and metastatic mucinous adenocarcinoma, with higher accuracy. Pax8 can be used as an important supplementary indicator of immunohistochemistry in the differential diagnosis of both tumors.