乙醇固定法、液基细胞学法与传统细胞学法诊断胆总管恶性狭窄的对比研究  

Diagnosis of malignant stricture of common bile duct： alcoholfixation, liquid-based cytology and con- ventional cytology

作　　者：于剑锋[1] 郝建宇[1] 吴东方[1] 郎海波[1] 

机构地区：[1]首都医科大学附属北京朝阳医院消化内科,北京100020

出　　处：《中华消化内镜杂志》2013年第12期678-681,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨乙醇固定法、液基细胞学法对胆总管恶性狭窄的诊断价值以及乙醇固定法从采样到固定的合适间隔时间。方法2008年10月至2013年6月经手术病理或2年临床随访确诊的胆总管恶性狭窄82例，统计其中乙醇固定法（乙醇固定法组，n=30）、液基细胞学法（液基细胞学法组，n=28）、传统细胞学法（传统细胞学法组，n=24）的刷检阳性率并行对比分析，同时比较乙醇固定法组中采样到固定间隔时间2min者（n=17）和5rain者（n=13）的刷检阳性率。结果乙醇固定法组、液基细胞学法组、传统细胞学法组刷检阳性率分别为73．33％（22／30）、75．00％（21／28）、20．83％（5／24）。传统细胞学法组刷检阳性率明显低于乙醇固定法组（∥=21．525，P=0．ooo）和液基细胞学法组（X2=22．208，P=0．000），差异均有统计学意义；乙醇固定法组与液基细胞学法组刷检阳性率相近，差异无统计学意义（X2=0．683，P=0．898）。乙醇固定法组中采样到固定间隔时间2min者刷检阳性率为88．24％（15／17），明显高于5min者的53．85％（7／13），差异有统计学意义（，=4．535，P=0．033）。结论乙醇固定法和液基细胞学法均可明显增加胆总管恶性狭窄的刷检阳性率，具有较好的临床应用价值；而乙醇固定法更加简便、成本低，但使用时应尽量缩短从采样到固定的间隔时间，建议不超过2min。Objective To explore the diagnostic value of alcohol fixation and liquid-based cytology method for malignant stricture of common bile duct and to study the interval time between sampling and fixa- tion for procedure of alcohol fixation. Methods Data of 82 patients were retrospectively studied, who were suspected of having malignant stricture of common bile duct underwent brushing through endoscopic retro- grade cholangiopancreatography （ERCP）, and were confirmed by follow-up for 2 years or pathology after sur- gery from October 2008 to June 2013. These patients were randomly divided into alcohol fixation group （ n = 30）, liquid-based cytology group （ n = 28 ） and conventional cytology group （ n = 24）. The positive diagnostic rates of brush cytology in each group were compared. The alcohol fixation group were randomly divided into 2- minute group and 5-minute group according to the interval time between sampling and fixation. Positive di- agnostic rates were also compared. Results The positive rates were 73.33% （ alcohol fixation group, 22/30 ）, 75.00% （ liquid-based cytology group, 21/28 ） and 20. 83% （ conventional cytology group, 5/24）, respectively. The positive rate of conventional cytology group was obviously lower than alcohol fixa- tion group （X2 = 21. 525, P = 0. 000） and liquid-based cytology group （X2 = 22. 208, P = O. 000） with sta- tistical significance. But the positive rate of alcohol fixation group was similar to the liquid-based cytology group （X2 = 0. 683, P = 0. 898 ）. In alcohol f＇Lxation group, the positive rate of 2-min group （88.24%, 15/17） was significantly higher than the 5-min group （53.85%. 7/13 ） with statistical significance （2 =4. 535, P = 0. 033 ）. Conclusion Compared with conventional fixation, alcohol fixation and liquid-based cytology can improve positive diagnostic rate of brushing during ERCP. The alcohol fixation is more simple in procedure and low in cost than liquid-based cytology. The interval time between sampling and fi

关 键 词：【关键词】胆总管恶性狭窄 细胞学检查 乙醇固定法 

分 类 号：R575.6[医药卫生—消化系统]