膜式超薄液基细胞学检测技术在肺癌诊断中的应用  

Application of ThinPrep cytology test in the diagnosis of lung cancer

作　　者：池琼[1] 郑纪阳[1] 戴新建[1] 郑永克[1] 陈身贤[1] 徐海苗[3] 黄晓萍[2] 

机构地区：[1]温州市第二人民医院呼吸内科,325000 [2]温州市第二人民医院病理科,325000 [3]浙江省肿瘤医院病理科

出　　处：《中华肿瘤杂志》2010年第3期221-224,共4页Chinese Journal of Oncology

基　　金：基金项目：浙江省温州市科技局科学技术项目（Y20080047）

摘　　要：目的探讨膜式超薄液基细胞学检测技术（TCT）在肺癌诊断中的应用价值。方法收集143例肺癌患者和139例非肺癌患者的支气管肺泡灌洗液（BALF）和（或）纤维支气管镜刷片标本353个，同时进行TCT和直接涂片法检测，比较两种方法的敏感度和特异度。结果TCT检测的敏感度为39．6％，特异度为99．4％，直接涂片法检测的敏感度为8．3％，特异度为100％，TCT检测的敏感度高于直接涂片法（P〈0．01），特异度差异无统计学意义（P〉0．05）。BALF的TCT检测敏感度为41．5％，特异度为100％；直接涂片法诊断的敏感度为5．2％，特异度为100％。纤维支气管镜刷片的TCT检测敏感度为35．1％，特异度为96．4％；直接涂片法诊断的敏感度为15．8％，特异度为100％。与直接涂片法比较，两种标本的TCT检测敏感度较高（P〈0．01），特异度差异无统计学意义（P〉0．05）。71例同时采集BALF和纤维支气管镜刷片患者，BALFTCT检测的敏感度（49．0％）高于纤维支气管镜刷片TCT检测的敏感度（32．7％，P〈0．05）。肺癌患者中，同时有TCT分类诊断和病理组织学诊断结果的标本有69个，TCT分类诊断和病理组织学诊断的总符合率为84．1％。结论TCT检测能提高肺癌的诊断率，BALF的TCT检测可推广应用于临床。Objective To explore the diagnostic value of ThinPrep cytology test （TCT） in lung cancer. Methods 353 cases of bronchoalveolar lavage fluid（BALF） and （or） bronchial brushing cytology （ 192 cases from lung cancer patients and 161 cases from benign lung disease patients） were detected with TCT and method of direct smear, respectively. The sensitivity and specificity of two methods was compared. Results The sensitivity and specificity of TCT were 39.6% and 99.4%. And which of direct smear method were 8.3% and 100%, respectively. The sensitivity of TCT was significantly higher than that of method of direct smear in the diagnosis of lung cancer （P 〈 0.01 ）. There were 71 patients who underwent BALF and bronchial brushing cytology simultaneously, the sensitivity of TCT of BALF was higher than that of bronchial brushing cytology（ P 〈0.05 ）. Of the 69 cases which had both TCT and histopathological results, TCT and pathology concordance rate was 84.1%. Conclusion TCT has more diagnostic value in lung cancer; BALF is more preponderant than bronchial brushing cytology by TCT in the diagnosis of lung cancer.

关 键 词：肺肿瘤 膜式超薄液基细胞学检测技术 直接涂片法 纤维支气管镜刷片 支气管肺泡灌洗液 

分 类 号：R734.2[医药卫生—肿瘤]