拞旂庮偺昦棟恌抐

-柶塽愼怓傪拞怱偵-

拞旂庮釃偺慻怐暘椶乮WHO戞4斉, 2015乯

忋旂宆拞旂庮丂Epithelioid mesothelioma

忋旂宆拞旂庮偺慻怐宆偼懡嵤偱偁傞丅廩幚惈solid丄態娗擕摢忬tubulopapillary丄嶕忬trabecular偑揟宆揑側慻怐憸偱偁傞偑丄旝彫擕摢忬micropapillary丄傾僨僲儅僩僀僪adenomatoid丄扺柧嵶朎忬clear cell丄堏峴宆transitional丄椶扙棊枌deciduoid丄懡宍宆pleomorphic丄儕儞僷慻怐媴條lymphohistiocytoid丄彫嵶朎small cell側偳傕偁傞丅懡偔偺忋旂宆拞旂庮偼嵶朎堎宆偑寉搙偱偁傞偑崅搙偺椺傕偁傞丅

忋恾. HE愼怓. 忋旂宆拞旂庮.

娻庮偲偺娪暿

忋旂宆拞旂庮偺恌抐偵偼丄柶塽愼怓偵傛傝拞旂庮偺梲惈儅乕僇乕偲堿惈儅乕僇乕傪専摙偟丄娻庮偱偼側偄偙偲傪妋擣偡傞丅

梲惈儅乕僇乕乮拞旂偺儅乕僇乕乯

梲惈儅乕僇乕偲偟偰丄姶搙丄摿堎搙偺崅偄calretinin丄WT1丄D2-40傪梡偄傞丅
偟偐偟丄calretinin偼攛娻丄棏憙燋塼惈態娻丄儔僀僨傿僢僸嵶朎庮側偳偱傕梲惈偵側傞偙偲偑偁傝丄D2-40偼攛娻偱傕梲惈偵側傞偙偲偑偁傝丄WT1偼棏憙燋塼惈態娻偼崅棪偵梲惈偵側傞偺偱拲堄偑昁梫偱偁傞丅
偙偺傛偆側偙偲偐傜丄拞旂庮偲恌抐偡傞偨傔偵偼丄彮側偔偲傕梲惈儅乕僇乕俀庬偑梲惈偱丄堿惈儅乕僇乕俀庬偑堿惈偱偁傞偙偲傪妋擣偡傞昁梫偑偁傞丅梲惈儅乕僇乕偺侾庬偺傒偑梲惈偱偁傞応崌傗堿惈儅乕僇乕偑梲惈偱偁傞応崌偼丄拞旂庮偺恌抐偼怲廳偵峴偆昁梫偑偁傞丅
埲壓偺儅乕僇乕偼拞旂偺儅乕僇乕偲偟偰偼摿堎搙偑掅偄丅

堿惈儅乕僇乕乮娻庮偺儅乕僇乕乯

CEA偼傕偭偲傕桳梡偱偁傞丅偦偺懠丄MOC31丄Ber-EP4丄BG8丄claudin 4側偳傪梡偄傞丅

斀墳惈拞旂偲偺娪暿

忋旂宆拞旂庮偼嵶朎堎宆偑寉搙偱偁傞偙偲偑懡偔丄斀墳惈拞旂偼崅搙偺堎宆惈傪帵偡偙偲偑偁傞偺偱丄偦偺娪暿偼擄偟偄丅忋旂宆拞旂庮偼EMA丄Glut-1丄CD146丄IMP3側偳偑梲惈偲側傝丄僨僗儈儞偑堿惈偲側傝丄斀墳惈拞旂偼EMA丄Glut-1丄CD146丄IMP3偑堿惈偲側傝丄僨僗儈儞偑梲惈偲側傞偙偲偑曬崘偝傟偰偄傞丅偟偐偟丄偙傟傜偺寢壥偼慡椺偵摉偰偼傑傞傢偗偱偼側偔丄偦偺寢壥偩偗偱拞旂庮偲恌抐偡傞偙偲偼偱偒側偄丅

忋恾嵍. 斀墳惈拞旂. 婥嫻偵敽偭偨拞旂偺憹惗偱偁傞偑丄EMA偑梲惈偱偁傞丅忋恾塃. 忋旂宆拞旂庮.

拞旂庮偼fluorescence in situ hybridization (FISH)偵傛傝p16/CDKN2A偺寚幐傪擣傔傞丅p16/CDKN2A 偺寚幐偺昿搙偼慻怐宆偵傛偭偰堎側傝丄擏庮宆偱偼傎傏100%偵擣傔傜傟傞丅堦曽丄斀墳惈拞旂偵偼p16/CDKN2A偺寚幐偼側偔丄FISH偵傛傞p16/CDKN2A偺寚幐偺桳柍傪拞旂庮偲斀墳惈拞旂偺娪暿偵棙梡偱偒傞丅

忋恾. FISH. Vysis CDKN2A/CEP9 FISH Probe. 儕儞僷媴乮彫偝側妀乯偼愒怓偺僗億僢僩(p16/CDKN2A)傪擣傔傞丅庮釃嵶朎乮戝偒側妀乯偼愒怓偺僗億僢僩傪擣傔側偄丅庮釃嵶朎偼p16/CDKN2A偑寚幐偟偰偄傞丅

擏庮宆丄慄堐宍惉宆拞旂庮Sarcomatoid, Desmoplastic mesothelioma

擏庮宆拞旂庮偼朼悕宍偺庮釃嵶朎偑憹怋偟丄懇忬攝楍偁傞偄偼柍拋彉側攝楍傪帵偡丅擏庮宆拞旂庮偼朎懱偑朙偐側傕偺偐傜嵶朎幙偺朢偟偄朼悗宍嵶朎傑偱條乆側宍懺傪帵偡丅妀堎宆傗妀暘楐憸偼栚棫偨側偄傕偺偐傜尠挊側傕偺傑偱條乆偱偁傞丅

忋恾. HE愼怓. 擏庮宆拞旂庮.

慄堐宍惉宆拞旂庮偼丄擏庮宆拞旂庮偺垷宆偱偁傞丅枾側銹尨慄堐偺憹惗傪敽偄丄埆惈拞旂嵶朎偑壴傓偟傠忬偁傞偄偼patternless pattern傪帵偟偰憹怋偡傞偑丄彮側偔偲傕銹尨慄堐偑50%傪挻偊側偗傟偽側傜側偄丅

忋恾. HE愼怓. 慄堐宍惉宆拞旂庮.

柶塽慻怐壔妛揑偵偼丄擏庮宆拞旂庮偼丄僒僀僩働儔僠儞乮AE1/AE3丄CAM5.2摍乯偑條乆側掱搙偵梲惈偲側傞丅擏庮宆拞旂庮偺偆偪僇儖儗僠僯儞偑梲惈偲側傞偺偼栺30亾偺徢椺偱丄D2-40偼偦傟埲忋偺徢椺偑梲惈偲側傞丅CK5/6丄WT1偺姶搙偼掅偄丅

攛擏庮條娻偲偺娪暿

嫻枌偺擏庮宆拞旂庮偺恌抐偵偼丄攛擏庮條娻偱偼側偄偙偲傪妋擣偡傞昁梫偑偁傞丅攛擏庮條娻傕僒僀僩働儔僠儞偑梲惈偱丄calretinin丄D2-40偑梲惈偵側傞偙偲傕偁傞丅TTF-1丄Napsin A丄p63丄p40偑梲惈偲側傞応崌偼攛擏庮條娻偲恌抐偱偒傞偑丄偙傟傜偑堿惈偺応崌偼丄攛擏庮條娻偲擏庮宆拞旂庮偺娪暿偼崲擄偱偁傞丅偙偺応崌丄曻幩慄夋憸傗庤弍昗杮偵傛傝庮釒偑攛偵懚嵼偡傟偽攛擏庮條娻偲峫偊丄庮釃偑嫻枌偵傃傑傫惈偵懚嵼偡傟偽擏庮宆拞旂庮偲峫偊傞丅

擏庮偲偺娪暿

擏庮偲偺娪暿偼丄擏庮宆拞旂庮偼僒僀僩働儔僠儞偑梲惈偱丄擏庮偼僒僀僩働儔僠儞偑堿惈偱偁傝丄擏庮偺桼棃嵶朎偵懳偡傞峈懱偑梲惈偱偁傞偙偲偵傛傝峴偆丅偟偐偟丄擏庮宆拞旂庮偺拞偵偼傑傟偵僒僀僩働儔僠儞偑堿惈偱偁傞偙偲偑偁傞丅椶忋旂擏庮丄寣娗擏庮丄埆惈慄堐惈慻怐媴庮丄屒棫惈慄堐惈庮釃側偳偺拞偵偼僒僀僩働儔僠儞偑梲惈偵側傞偙偲偑偁傞偺偱拲堄偑昁梫偱偁傞丅妸枌擏庮偼丆translocation t(X;18)(p11;q11)偑懚嵼偡傞偨傔丄RT-PCR傗FISH偵傛傝偙偺揮嵗傪徹柧偡傞偙偲偵傛傝恌抐偱偒傞丅

忋恾嵍. HE愼怓. 妸枌擏庮. 忋恾塃. FISH. Vysis SS18 Break Apart FISH Probe. 愒偲椢偺僗億僢僩偑暘偐傟偰偍傝丄揮嵗偑懚嵼偡傞丅

擇憡宆拞旂庮biphasic mesothelioma

傃傑傫惈擇憡惈埆惈拞旂庮偼忋旂宆惉暘偁傞偄偼擏庮宆惉暘偑彮側偔偲傕10亾埲忋懚嵼偡傞拞旂庮偱偁傞丅
忋旂宆拞旂庮偵傒傜傟傞娫幙惉暘偼嵶朎枾搙偑崅偔丄堎宆惈傪帵偡偙偲偑偁傞丅偙偺応崌丄娫幙惉暘偑庮釃惉暘側傜偽擇憡宆拞旂庮偵側傞丅偙偺娪暿偑擄偟偄徢椺偑懚嵼偡傞丅

傑偲傔

彫偝側惗専昗杮偺昦棟妛揑強尒偑拞旂庮偺傛偆偵尒偊偰傕丄幚嵺偵偼拞旂庮偱偼側偄偙偲偑偁傞丅昦棟妛揑偵拞旂庮偺傛偆偵尒偊偰傕丄侾擭娫宱夁傪尒偰丄夋憸忋庮釒偑擣傔傜傟側偗傟偽丄懡偔偼拞旂庮偱偼側偄丅媡偵丄昦棟妛揑偵墛徢惈曄壔偺傛偆偵尒偊偰傕丄悢偐寧屻偵庮釒偑憹戝偟偨応崌偼丄嵞惗専偱柧傜偐側拞旂庮偺強尒偑摼傜傟傞偙偲偑懡偄丅拞旂庮偺恌抐偼昦棟強尒偺傒偱峴傢偢丄椪彴宱夁丄夋憸強尒丄嵶朎恌強尒側偳偐傜憤崌揑偵峴偆傋偒偱偁傞丅椪彴堛偲偺懳榖偼廳梫偱偁傞丅

堷梡暥專

  1. Travis WD, Brambilla E, et al. WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart (World Health Organiztion Classification of Tumours). World Health Organization, 2015.
  2. Husain AN, Colby T, et al. Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med 2013;137:647-667.
  3. Ordonez NG. What are the current best immunohistochemical markers for the diagnosis of epithelioid mesothelioma? A review and update. Hum Pathol. 2007;38:1-16.
  4. Ordonez NG. Application of immunohistochemistry in the diagnosis of epithelioid mesothelioma: a review and update. Hum Pathol. 2013;44:1-19.
  5. Wu D, Hiroshima K, et al. Diagnostic usefulness of p16/CDKN2A FISH in distinguishing between sarcomatoid mesothelioma and fibrous pleuritis. Am J Clin Pathol. 2013;139:39-46.
  6. Yoshino M, Sekine Y, et al. Pericardial synovial sarcoma: a case report and review of the literature. Surg Today. 2014;44:2167-2173.
  7. Goldberg M, Imbernon E, et al. The French National Mesothelioma Surveillance Program. Occup Environ Med. 2006;63:390-395.
  8. Takeshima Y, Inai K, et al. Accuracy of pathological diagnosis of mesothelioma cases in Japan: clinicopathological analysis of 382 cases. Lung Cancer. 2009;66:191-197.

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