液基薄层细胞学检测技术在肺癌诊断中的作用
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摘要
目的探讨液基薄层细胞学检测(TCT)技术在肺癌诊断中的应用价值。方法收集400例肺癌患者和200例非肺癌患者的痰液、胸腔积液、支气管肺泡灌洗液及支气管刷片共600例,同时进行TCT和传统涂片法(CS)检测,比较两种方法的敏感度和特异度。结果 TCT检测的敏感度为73.0%,特异度为97.5%,CS法检测的敏感度为29.0%,特异度为99.5%,TCT检测的敏感度高于CS法(P<0.05)。TCT法在涂片质量、判断癌细胞形态学方面均较CS法好。TCT分类诊断和病理组织学诊断的总符合率为86.6%。TCT分类诊断和细胞蜡块结合免疫细胞化学诊断的总符合率为89.0%。结论 TCT检测法能明显提高肺癌细胞的阳性检出率,值得推广应用。
Objective To explore the diagnostic value of ThinPrep cytology test( TCT) in lung cancer. Methods Six hundred samples of sputum,pleural effusion,alveolar lavage fluid and bronchial mucosa brush were collected,including 400 cases of lung cancer patients and 200 cases of benign lung disease patients. They were detected by TCT and method of conventional smear( CS),respectively. The sensitivity and specificity of the two methods were compared. Results The sensitivity of TCT was higher than that of CS( 73. 0% vs 29. 0%,P < 0. 05) and the specificities of TCT and CT were 97. 5% and 99. 5%,respectively. TCT is better than CS in the smear quality and the morphology of cancer cell. TCT concordance rates with histopathological diagnosis and diagnosis of cell block in combination with immunocytochemistry were 86. 6% and 89. 0%,respectively. Conclusions TCT can increase the detection rate of lung cancer and is worthy of application in clinical practice.
Objective To explore the diagnostic value of ThinPrep cytology test( TCT) in lung cancer. Methods Six hundred samples of sputum,pleural effusion,alveolar lavage fluid and bronchial mucosa brush were collected,including 400 cases of lung cancer patients and 200 cases of benign lung disease patients. They were detected by TCT and method of conventional smear( CS),respectively. The sensitivity and specificity of the two methods were compared. Results The sensitivity of TCT was higher than that of CS( 73. 0% vs 29. 0%,P < 0. 05) and the specificities of TCT and CT were 97. 5% and 99. 5%,respectively. TCT is better than CS in the smear quality and the morphology of cancer cell. TCT concordance rates with histopathological diagnosis and diagnosis of cell block in combination with immunocytochemistry were 86. 6% and 89. 0%,respectively. Conclusions TCT can increase the detection rate of lung cancer and is worthy of application in clinical practice.
引文
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[4]陈江帆,姜海娇,祝迪,等.MOC-31和CD44v6在良恶性腹水鉴别诊断中的应用[J].中国组织化学与细胞化学杂志,2013,22(5):411-415.
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[6]虞红珍,吴强,秦蓉,等.联合组织学与细胞学对肺小细胞癌的诊断和鉴别诊断[J].临床与实验病理学杂志,2012,28(1):61-64.
[7]刘尽国,张杰,张俭,等.液基薄层细胞学与免疫细胞化学联合在肺癌分型及鉴别诊断中的应用[J].临床与实验病理学杂志,2013,29(8):871-875.
[8]陈学敬,周立娟,曲杨,等.沉渣包埋联合免疫组化在胸水转移性肺腺癌与胸膜恶性间皮瘤鉴别诊断中的应用[J].诊断病理学杂志,2014,21(5):263-266.
[2]马丽,文仲光.肺癌早期筛查及诊断方法的研究进展[J].中国肿瘤临床与康复,2014,21(11):1406-1408.
[3]陈江帆,杜明伟,姜海娇,等.免疫细胞化学方法对胸腔积液中恶性肿瘤细胞的分类与诊断[J].中国组织化学与细胞化学杂志,2013,22(1):49-53.
[4]陈江帆,姜海娇,祝迪,等.MOC-31和CD44v6在良恶性腹水鉴别诊断中的应用[J].中国组织化学与细胞化学杂志,2013,22(5):411-415.
[5]贾伟,黄礼年.液基薄层细胞学在肺癌诊断中的进展[J].中华全科医学,2012,10(7):1133-1134.
[6]虞红珍,吴强,秦蓉,等.联合组织学与细胞学对肺小细胞癌的诊断和鉴别诊断[J].临床与实验病理学杂志,2012,28(1):61-64.
[7]刘尽国,张杰,张俭,等.液基薄层细胞学与免疫细胞化学联合在肺癌分型及鉴别诊断中的应用[J].临床与实验病理学杂志,2013,29(8):871-875.
[8]陈学敬,周立娟,曲杨,等.沉渣包埋联合免疫组化在胸水转移性肺腺癌与胸膜恶性间皮瘤鉴别诊断中的应用[J].诊断病理学杂志,2014,21(5):263-266.