食管癌液基细胞学筛查方法研究  

Liquid-based cytology for esophageal carcinoma screening

作　　者：郭会芹[1] 魏文强[2] 吕宁[1] 曹箭[1] 李中林[1] 王乃朋[1] 王国清[3] 潘秦镜[1] 乔友林[2] 

机构地区：[1]中国协和医科大学中国医学科学院肿瘤医院肿瘤研究所病理科,北京100021 [2]中国协和医科大学中国医学科学院肿瘤医院肿瘤研究所流行病学研究室,北京100021 [3]中国协和医科大学中国医学科学院肿瘤医院肿瘤研究所腔镜科,北京100021

出　　处：《癌症》2009年第12期1243-1247,共5页Chinese Journal of Cancer

基　　金：美国国立癌症研究所(NCI)食管癌早诊早治项目(EDEC)(项目编号:N01-RC-47702)~~

摘　　要：背景与目的:食管拉网细胞学作为高发区无症状人群食管癌筛查的检查方法已经开展了数十年,但是拉网细胞学由于敏感性较低而限制了它自身的发展。本研究旨在在食管拉网细胞学中引入液基细胞学,探讨液基细胞学在我国食管癌拉网细胞学筛查中的应用价值。方法:对河南省林州市姚村镇的无症状居民进行拉网细胞学检查,受检者同时进行食管拉网液基细胞学TBS分级诊断和食道镜活检。以食道镜活检组织学诊断结果为标准,评估液基细胞学的敏感性和特异性。结果:在710例受检者中,食道镜活检组织学诊断原位癌及其以上病例17例(2.4%)。以细胞学非典型鳞状细胞或非典型腺细胞(ASC/AGC)及其以上诊断为阳性,液基细胞学诊断的敏感性和特异性分别为76.5%和76.0%。结论:在传统细胞学发展水平较高的医疗单位,液基制片技术对食管癌诊断的敏感性的提高作用并不明显,但可显著降低阅片人员的工作负荷。Background and Objective. Cytologic screening of asymptomatic high risk individuals can detect curable esophageal carcinomas and has been used for several decades. However, the sensitivity of such screening is relatively low, which limits its wide use and development. This study was to investigate the utility of liquid-based cytology in esophageal carcinoma screening. Methods= A mass screening of esophageal carcinoma was performed for asymptomatic residents in Yaocun County, Linzhou City, Henan Province, China. Esophageal biopsy samples were put into a liquid buffer for cytologic diagnosis and subsequent endoscopic biopsies were made on all subjects. Cytologic categories were adapted from criteria of the Bethesda system （TBS）. Results of liquid-based cytology were compared with those from endoscopic biopsy. The sensitivity and the specificity of liquid-based cytology were evaluated. Results. Carcinomas in situ and carcinomas were identified in 17 （2.4%） of 710 subjects. Measured by ASC/AGC （atypical squamous cells or atypical glandular cells） as the detection threshold, the sensitivity and the specificity of liquid-based cytology were 76.5% and 76.0%, respectively. Conclusion： In a hospital with a high level of conventional cytology, liquid-based technique can be used widely since the work load of reading slides may greatly decrease, although this technique do not significantly improve the sensitivity of screening.

关 键 词：食管肿瘤 拉网 液基薄片 筛查 活检 

分 类 号：R735.1[医药卫生—肿瘤]