液基薄层细胞学技术在甲状腺细针穿刺诊断甲状腺结节中的应用研究  

Application of thinprep cytology in the diagnosis of thyroid nodules by thyroid fine needle aspiration

作　　者：徐冬香[1] 游庆华[2] 王爱华[1] 叶慧英[2] 张俊[3] 叶敏[4] 

机构地区：[1]复旦大学附属浦东医院内分泌科,上海201399 [2]复旦大学附属浦东医院病理科,上海201399 [3]复旦大学附属浦东医院B超室,上海201399 [4]复旦大学附属浦东医院普外科,上海201399

出　　处：《实用临床医药杂志》2014年第9期27-30,共4页Journal of Clinical Medicine in Practice

基　　金：上海市浦东新区卫生局科技发展基金项目(pw2010A-19)

摘　　要：目的：探讨液基薄层细胞制片技术在甲状腺细针穿刺诊断甲状腺结节的应用价值。方法收集2010年8月-2012年10月125例在本院内分泌科和外科手术的患者，应用液基膜式薄层细胞制作技术（TCT）和传统制片技术（CS）对125例甲状腺细针穿刺标本进行对比分析。结果显示 TCT 具有以下特点：细胞数量明显增加，细胞形态结构清晰，尤其是能清晰观察到细胞核的多形性、拉长或不规则的核膜、核沟和核内包涵体，细胞呈单层排列，涂片背景干净，血细胞和杂质少。TCT 和与 CS 在细胞学诊断分类比较上的差异比较明显，但尚不具有统计学意义（χ2＝7．727，P ＝0．052＞0．05）。TCT 与病理诊断结果的符合率为98．9％，高于 CS 与病理诊断结果的符合率90．3％，差异有统计学意义（χ2＝6．764，P ＝0．009＜0．05）。TCT 组的准确率、敏感性、特异性均显著高于 CS 组，差异有统计学意义（P ＜0．01）。结论TCT 可以提高甲状腺穿刺制片质量、敏感性、特异性、病理诊断准确率和符合率，具有临床应用及推广价值。Objective To explore the value of thinprep cytology in the diagnosis of thyroid nodules by thyroid fine needle aspiration.Methods Liquid-based thin-film cell production technology （TCT）and traditional producers technology （CS）were used in detection of 125 specimens by thyroid fine needle aspiration.Results TCT had the following characteristics ：significant increased in cell number,cell morphology clear structure could be clearly observed especially pleomorphic nuclei,elon-gated or irregular nuclear membrane,nuclear grooves and nuclear inclusions,the cells showed a single layer arrangement,smear clean background,less blood cells and impurities.TCT and CS differences in the classification of cytologic diagnosis was obvious （χ2 =7.727,P =0.052 〉0.05）.TCT results in line with the pathological diagnosis was 98.9%,which was higher than CS and pathological diagno-sis compliance rate of 90.3% （χ2 =6.764,P =0.009 〈0.05）.Accuracy,sensitivity and specificity in TCT group were better than CS （P 〈0.01）.Conclusion TCT producers can improve the quality of thyroid biopsy,sensitivity,specificity and accuracy of pathological diagnosis coincidence rate,so it is worthy of clinical application and popularization.

关 键 词：液基薄层细胞学 细针穿刺 甲状腺 

分 类 号：R581[医药卫生—内分泌]