细针吸取细胞学检查用于阴道残端结节的诊断研究
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摘要
[目的]探讨阴道残端结节细针吸取细胞学检查(fine needle aspiration cytology,FNAC)的临床应用价值。[方法 ]选取115例阴道残端结节患者,随机分成两组,试验组68例阴道残端结节采用FNAC检查;对照组47例采用传统液基细胞学检查,两组患者均进行组织学结果对比研究,分析细胞形态特点与鉴别诊断,比较两种方法诊断的敏感性、特异性和符合率,并分析结节大小、肿瘤分期、首次根治及放化疗至复发的间隔时间与阳性率的关系。[结果]阴道残端结节FNAC检查作为阴道残端肿瘤复发诊断方法的敏感性为90.1%,符合率为92.6%,假阴性率9.8%,假阳性率为0,其中敏感性和假阴性结果显著优于传统液基细胞学方法(P<0.05)。[结论]阴道残端结节FNAC检查可以准确、微创地对阴道残端结节性质进行病理学诊断,具有较高的临床应用价值。
[Objective] To evaluate the clinical application of fine needle aspiration cytology(FNAC) in the diagnosis of vaginal stump nodules after total hysterectomy. [Methods] One hundred and fifteen patients with vaginal stump nodules after total hysterectomy were randomly divided into two groups:68 cases in study group underwent FNAC,and 47 cases in control group received liquid-based cytology. The diagnostic sensitivity,specificity,and coincidence rate of two groups were compared. The relationship of tumor recurrence with tumor size,tumor stage,the duration of initial radical operation or chemotherapy was analyzed. [Results] The sensitivity of vaginal stump nodules FNAC in diagnosis of vaginal stump tumor recurrence was 90.1%,specificity was 100.0% and coincidence rate was 92.6%,which were significantly better than those of liquidbased cytology method(P<0.05). [Conclusion] FNAC can be used for pathological diagnosis of the recurrence of vaginal stump tumor after total hysterectomy,which has value of clinical application.
[Objective] To evaluate the clinical application of fine needle aspiration cytology(FNAC) in the diagnosis of vaginal stump nodules after total hysterectomy. [Methods] One hundred and fifteen patients with vaginal stump nodules after total hysterectomy were randomly divided into two groups:68 cases in study group underwent FNAC,and 47 cases in control group received liquid-based cytology. The diagnostic sensitivity,specificity,and coincidence rate of two groups were compared. The relationship of tumor recurrence with tumor size,tumor stage,the duration of initial radical operation or chemotherapy was analyzed. [Results] The sensitivity of vaginal stump nodules FNAC in diagnosis of vaginal stump tumor recurrence was 90.1%,specificity was 100.0% and coincidence rate was 92.6%,which were significantly better than those of liquidbased cytology method(P<0.05). [Conclusion] FNAC can be used for pathological diagnosis of the recurrence of vaginal stump tumor after total hysterectomy,which has value of clinical application.
引文
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[6]Wilkinson AR,Mahore SD,Maimoon SA,et al.FNAC in the diagnosis of lymph node malignancies:a simple and sensitive tool[J].Indian J Med Paediatr Oncol,2012,33(1):21-24.
[7]Huang YJ,Shu QJ.The role of fine needle aspiration cytology in the diagnosis of breast lesions[J].Journal of Chinese Oncology,2003,9(2):120-121.[黄玉军,舒琦瑾.细针穿刺细胞学检查在乳腺肿块诊断中的意义[J].肿瘤学杂志,2003,9(2):120-121.]
[8]Usmani S,Ahmed N,Saleh NA,et al.The clinical utility of combining pre-operative axillaryultrasonography and fine needle aspiration cytology withradionuclide guided sentinel lymph node biopsy in breast cancerpatients with palpable axillary lymph nodes[J].Eur J Radiol,2015,84(25):15-25.
[9]Gayathri BN,Kalyani R,Harendra Kumar ML,et al.Fine needle aspiration cytology of Hashimoto’s thyroiditis—a diagnostic pitfall with review of literature[J].J Cytol,2011,28(4):210-213.
[10]Henrys CE,Grigg R.Use of fine-needle aspiration cytology in the diagnosis of parotid neoplasms[J].ANZ J Surg,2015,85(11):838-842.
[11]Khanlari M,Daneshbod Y,Shaterzadeh Yazdi H,et al.Discrepancy of target sites between clinician and cytopathological reports in head neck fine needle aspiration[J].Cancer Med,2015,4(9):1374-1380.
[2]He Y,Wu YM.Advances in screening and diagnostic methods in stump vaginal intraepithelial neoplasia[J].Chinese Journal of Clinical Obstetrics and Gynecology2014,15(5):478-480.[何玥,吴玉梅.残端阴道上皮内瘤变的筛查及诊断方法进展[J].中国妇产科临床杂志,2014,15(5):478-480.]
[3]Shen JH.Application of a self-made positioning towel for disinfection in surgery requiring lithotomy position[J].Journal of Nursing Science,2015,30(10):41-42.[沈剑辉.自制膀胱截石位定位消毒铺巾用品的应用[J].护理学杂志,2015,30(10):41-42.]
[4]He Y,Wu Y,Zhao Q,et al.Clinical analysis of patients underwent hysterectomy for stageⅠcervical cancer or high grade cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia[J].Chinese Journal of Obstetrics and Gynecology,2015,50(7):516-521.[何玥,吴玉梅,赵群,等.Ⅰ期子宫颈癌和子宫颈上皮内瘤变Ⅲ患者合并阴道上皮内瘤变的临床分析[J].中华妇产科杂志,2015,50(7):516-521.]
[5]Yang SL,Duan W,Miao JW,et al.Clinical analysis of abnormal cytology cases in vaginal stump in 107 cases[J].Chinese Journal of Medicine,2013,48(8):73-75.[杨淑丽,段微,苗劲蔚,等.阴道残端细胞学异常病例107例临床分析[J].中国医刊,2013,48(8):73-75.]
[6]Wilkinson AR,Mahore SD,Maimoon SA,et al.FNAC in the diagnosis of lymph node malignancies:a simple and sensitive tool[J].Indian J Med Paediatr Oncol,2012,33(1):21-24.
[7]Huang YJ,Shu QJ.The role of fine needle aspiration cytology in the diagnosis of breast lesions[J].Journal of Chinese Oncology,2003,9(2):120-121.[黄玉军,舒琦瑾.细针穿刺细胞学检查在乳腺肿块诊断中的意义[J].肿瘤学杂志,2003,9(2):120-121.]
[8]Usmani S,Ahmed N,Saleh NA,et al.The clinical utility of combining pre-operative axillaryultrasonography and fine needle aspiration cytology withradionuclide guided sentinel lymph node biopsy in breast cancerpatients with palpable axillary lymph nodes[J].Eur J Radiol,2015,84(25):15-25.
[9]Gayathri BN,Kalyani R,Harendra Kumar ML,et al.Fine needle aspiration cytology of Hashimoto’s thyroiditis—a diagnostic pitfall with review of literature[J].J Cytol,2011,28(4):210-213.
[10]Henrys CE,Grigg R.Use of fine-needle aspiration cytology in the diagnosis of parotid neoplasms[J].ANZ J Surg,2015,85(11):838-842.
[11]Khanlari M,Daneshbod Y,Shaterzadeh Yazdi H,et al.Discrepancy of target sites between clinician and cytopathological reports in head neck fine needle aspiration[J].Cancer Med,2015,4(9):1374-1380.