痰液基薄层技术在肺癌诊断中的价值及影响因素分析  

Value of ThinPrep Sputum Cytology in the Diagnosis of Lung Cancers and its Influencing Factors

作　　者：卢珊珊[1] 曹箭[1] 潘秦镜[1] 赵琳琳[1] 李中林[1] 王乃朋[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院病理科,北京100021

出　　处：《中国医刊》2010年第1期44-46,共3页Chinese Journal of Medicine

摘　　要：目的探讨应用液基薄层技术痰细胞学检查在肺癌诊断中的价值及影响其检出率的相关因素。方法查阅1775例痰细胞学患者的病例资料,对其临床TNM分期、病理大体分型、组织学诊断、肿瘤部位、大小等资料进行分析总结。结果痰细胞学的敏感性34.53%,特异性99.47%。与病理分型诊断的符合率:鳞癌为96.90%,腺癌为95.65%,小细胞癌为100%。痰细胞学检出率:中央型肺癌高于周边型肺癌(39.13%:27.27%),鳞癌最高、小细胞癌次之、腺癌最低(46.13%:39.42%:27.71%)。中晚期肺癌高于早期肺癌(临床TNM分期Ⅰ～Ⅳ期:痰细胞学检出率分别为32.21%、35%、40.68%和63.78%)。肿瘤直径≥2cm者比直径<2cm者更易检出(41.26%:8.15%)。结论痰细胞学诊断易受多种因素影响,其敏感性较低但特异性高、分型准确,可为临床治疗提供可靠的诊断依据。Objective To evaluate the role of ThinPrep sputum cytology in the diagnosis of lung cancers, and to analysis the factors that associated with the sensitivity. Methods The results of 1775 patients were retrospectively analyzed,the results included TNM stage, macroscopy and histologic types, location and the size of tumour. Results The sensitivity and specificity of sputum cytology were 34.53% and 99.47%. The total cytotyping accuracy was 96. 84%, 96.90% in squamous carcinoma, 95.65% in adenocarcinoma and 100% in small cell carcinoma. Sensitivity ： central lung cancers 〉 peripheral lung cancers（ 39.13% ： 27.27% ）, squamous carcinoma 〉 small cell carcinoma 〉 adenocarcinoma（46.13% ： 39.42% ： 27.71% ）. Well differentiated squamous carcinoma have a higher sensitivity than poorly differentiated squamous carcinoma（61.11%：42.19% ） ,but in adenocarcinoma the result is opposite（22.81% ： 25.23% ）. The advancd cases have a higher sensitivity than the early stage（ stage I - IV ： 32.21%, 35% ,40.68% and 63.78% ）. The sensitivity for tumors ≥2 cm in diameter was higher than tumors with a diameter of 〈2 cm （41.26%：8. 15% ）. Conclusion Sputum cytology is presently a promising approach for lung cancer screening, it is low in sensitivity and many factors can affected its sensitivity, but it provides a high specificity and a reliable cytotyping diagnosis, so it is applicable for clinical testing.

关 键 词：痰细胞学 肺癌 敏感性 液基薄层技术 

分 类 号：R734.2[医药卫生—肿瘤]