液基细胞学在肺癌支气管刷片检查中的应用价值  

Clinical value of liquid based cytology test in brushing examination of patients with lung cancer

作　　者：武春燕[1] 王彦丽[1] 陈岗[1] 朱美芳[1] 赵云兰[1] 李辉[1] 

机构地区：[1]同济大学附属肺科医院病理科,上海200433

出　　处：《同济大学学报（医学版）》2009年第3期65-69,共5页Journal of Tongji University(Medical Science)

摘　　要：目的液基细胞学检查系统(liquid based cytology test,LCT)已成功而广泛地应用于宫颈细胞学诊断,而用于支气管刷片细胞学诊断国内外报道均很少。本研究试图探讨LCT在肺癌患者支气管刷检检查中的应用价值。方法选取712例同时进行了刷检传统涂片细胞学检查,刷检液基细胞学检查和组织学(活检和/或手术)检查,计算涂片和LCT的敏感度、特异度及分型的符合率。结果LCT和传统涂片法诊断肺癌敏感度分别为70.55%和61.15%;两者的特异度分别为85.65%和87%;刷检液基细胞学对常见肺癌分型的符合率均较传统涂片高,特别是对腺癌诊断的符合率,液基细胞学(82.0%)明显优于传统涂片(64.8%)(χ2=7.419,P=0.006)。分型符合的一致性检验的Kappa值分别为0.970和0.960。结论LCT是在支气管刷检制片、染色等方面便于实施质量控制的一项新技术,是一种诊断肺癌的可靠方法,敏感度高,对组织学分型亦有较高的参考价值。Objective Liquid based cytology test （LCT） has been applied for cervical cytological diagnosis successfully and widely. However, there are few reports about brush cytological diagnosis at present. The aim of this study is to evaluate the value of LCT in cytological diagnosis of brush examination of patients with lung cancer. Methods Seven hundred and twelve patients received conventional smear test, LCT and bronchial biopsy/operation. The sensitivity, specificity and agreement on histopathologic type of conventional smear test and LCT were analyzed. Results The sensitivity of LCT and conventional smear in diagnosing lung cancer were 70. 55% and 61. 15% respectively, the specificity were 85. 65% and 87% respectively. In histological typing study, especially for adenocarcinoma, the accordance rate was higher by LCT （82.0%） than that by conventional smear test （ 64.8% ） （χ^2 = 7. 419, P = 0. 006 ）. The Kappa values of agreement on histopathologic type were 0.970 and 0.960 respectively. Conclusion LCT is a new technique that is convenient for practicing quality control in preparing smear and staining. It emerges with high sensitivity and credibility in the diagnosis of lung cancer, as well as superior precision in distinguishing general histological types.

关 键 词：支气管刷检 细胞病理学 肺肿瘤 液基细胞学 

分 类 号：R734.2[医药卫生—肿瘤]