痰脱落细胞学检查的敏感性及其影响因素  

Sensitivity of Sputum Cytology and Its Influencing Factors

作　　者：郭会芹[1] 曹箭[1] 李中林[1] 王乃鹏[1] 张智慧[1] 赵琳琳[1] 潘秦镜[1] 

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

出　　处：《肿瘤防治研究》2010年第2期197-200,共4页Cancer Research on Prevention and Treatment

摘　　要：目的探讨痰细胞学检查的敏感性,分析肿瘤部位、组织学类型、肿瘤分期、送检次数和制片方法等因素对敏感性的影响。方法收集2005年1～12月于我院行痰细胞学检查的肺癌住院患者743例,所有患者被要求连续送痰三次,其中第一次痰标本应用传统涂片(CP)和ThinPrep液基制片(TP)两种制片方法,第二次和第三次痰标本仅应用传统涂片。最后收集患者的临床病理资料,分析细胞学检查的敏感性及其相关因素。结果痰细胞学检查总的敏感性为34.7%,其中,中央型肺癌为45.6%,周边型肺癌为26.9%;鳞状细胞癌为46.3%,小细胞癌为31.3%,腺癌为27.0%;Ⅰ～Ⅳ期肺癌的敏感性分别为21.6%、31.9%、42.6%和41.3%。另外,有560例患者的第一次痰标本同时应用了TP和CP两种制片方法,TP的敏感性为30.4%,CP的敏感性为19.3%。CP的敏感性随送检次数的增加而增加,三次CP的累计敏感性达33.8%。结论痰细胞学检查的敏感性较低,并且受肿瘤部位、组织学类型和肿瘤分期等因素的影响。增加痰检次数和采用ThinPrep液基制片可在一定程度上提高痰细胞学检查的敏感性。Objective To approach the sensitivity of sputum cytology and elucidate the influence of tumor location, histologic tumor type, tumor stage, specimens number and preparation method on the sensitivity. Methods From January 2005 to December 2005, there were 743 lung cancer patients investigated by sputum collection. Sputum was collected for three consecutive days, whenever possible. The first samples were processed by two different preparation methods （conventional preparation and ThinPrep）. The second and the third samples were only processed by conventional preparation （CP）. Results The overall sensitivity of the sputum was 34.7%. Sensitivity in central and peripheral carcinomas was 45.6% and 26.9%, respectively. Regarding tumor type, 46.3% squamous cell carcinoma, 31.1% small cell carcinoma and 27.0% adeno carcinomas could be diagnosed. Sputum sensitivity also showed relations to tumor stages. In stage Ⅰ-Ⅳ tumor the sensitivity was 21.6%, 31.9%, 42.6% and 41.3%, respectively. There were 560 patients whose first samples were processed both by ThinPrep （TP） and CP. The sensitivity was 30.4% and 19.3%, respectively. The sensitivity of CP was increased with the number of specimens. By examining three specimens, the sensitivity achieved 33.8%. Conclusion The sensitivity of sputum cytology is low, and it influenced by the histologic types, location or stage of the tumor. Using TP method and increasing specimen numbers can improve the sensitivity of sputum within certain extent.

关 键 词：痰 敏感性 THINPREP 

分 类 号：R730.4[医药卫生—肿瘤]