术中积液或冲洗液细胞学诊断准确性和临床应用价值的探讨  

The clinical application value of intraoperative effusion or washing cytology and its accuracy

作　　者：朱艳丽[1] 赵琳琳[1] 赵焕[1] 潘秦镜[1] 郭会芹[1] 曹箭[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细胞学室,北京100021

出　　处：《中国医刊》2014年第4期52-54,共3页Chinese Journal of Medicine

摘　　要：目的探讨术中积液或冲洗液细胞学诊断准确性和临床应用价值。方法整理本院521例术中积液和冲洗液细胞学诊断,随诊所有病例的术后病理结果,复阅细胞学假阳性和假阴性涂片,分析术中细胞学涂片特点及诊断准确性,并探讨其临床应用价值。结果 521例积液或冲洗液中,恶性细胞检出率为40.32%,病理诊断有腹腔转移的恶性细胞检出率为84.9%。本研究有9例假阳性,18例假阴性。增生活跃的间皮细胞和宫内膜异位上皮细胞与高分化腺癌难以区别,是造成假阳性诊断的主要原因。炎细胞和血细胞多恶性肿瘤难以检出是造成假阴性的主要原因。结论术中细胞学检查有较高的检出率和一定的诊断准确性,对患者的后续治疗和预后有辅助参考价值。Objective To evaluate the clinical application value of intraoperative effusion or washing cytology and its accuracy. Method 521 patients in our hospital were enrolled. Their cytological diagnosis and histological diagnosis after surgery were compared to analyses the characteristics of the smears by reviewing the false-positive and false-negative slides and to evaluate its accuracy and clinical application value. Result During the 521 intraoperatively obtained samples the detection rate of the malignant cells was 40. 32%, whereas the detection rate of the cases that had peritoneal metastasis by histopathology was 84. 9%. In the current study, there were 9 false-positive and 18 false-negative cases. The main reason for the false-positive was that it＆#39;s difficult to discriminate the endometriosis or the mesothelial cell hyperplasia from the well-differentiated adenocarcinoma, while the main reason for the false-neg-ative was the low detection sensitivity caused by the Inflammatory cells and the hemocytes. Conclusion The rate of detection of intraoperative cytology were relatively high and it had certain accuracy. Therefore it had reference value for the patients＆#39; follow-up treatments and prognosis.

关 键 词：术中冲洗液 积液 细胞学 诊断 恶性肿瘤 

分 类 号：R36[医药卫生—病理学]