液基细胞制片术在纤维支气管镜抽吸物检测中的应用  

Application of liquid based cytology test in detection of fiber bronchoscopic aspirates

作　　者：万涛[1] 黄习臣[1] 粟毅[1] 李岱容[1] 

机构地区：[1]重庆医科大学附属第一医院呼吸内科,400016

出　　处：《重庆医学》2014年第33期4500-4502,共3页Chongqing medicine

基　　金：国家临床重点专科建设项目经费资助(卫办医政函[2012]949号)

摘　　要：目的探讨液基细胞制片技术在纤维支气管镜抽吸物检测中的应用价值。方法采用安必平(LBP)沉降式液基细胞制片系统并结合传统涂片方法处理纤维支气管镜抽吸标本2 000例,制成薄片,显微镜下观察,进行细胞学诊断。结果液基细胞制片法共检出细胞学阳性病例614例(30.7%),其中鳞癌267例(13.4%),腺癌217例(10.9%),小细胞癌83例(4.2%),未定型癌47例(2.4%)。液基制片法诊断肺癌敏感度为64.6%,传统涂片法诊断肺癌敏感度为49.2%。同时发现真菌阳性7例,结核病典型的干酪样坏死35例。结论液基细胞制片比传统方法制备的涂片背景更干净,细胞结构保持完整,阅片效率更高,癌细胞检出的阳性率得到提高,两种方法同时采用能最大限度提高纤维支气管镜细胞学检测的准确性和阳性检出率,同时还能为真菌、结核菌感染提供诊断依据。Objective To study liquid based cytology test and its application values in the detection of fiber bronchoscopic aspi‐rates .Methods LBP sedimentation type of ThinPrep cell production system combined with the conventional smear were used to de‐tect 2000 specimens of fiber bronchoscopic aspirates ,and conduct microscope observation and cytological diagnosis .Results Based on liquid based cytology cell production method ,there were 614 positive cases （30 .7% ） ,267 cases of squamous cell carcinoma （13 .4% ） ,and 217 cases of adenocarcinoma（10 .9% ） ,83 cases of small cell carcinoma （4 .2% ） ,and 47 cases of undifferentiated car‐cinoma （2 .4% ） .The diagnostic sensitivity for lung cancer of liquid‐based cytology test was 64 .6% and conventional smear was 49 .2% .We also found 7 cases of fungus positive ,35 cases of typical caseous necrosis with liquid based cytology test .Conclusion The ThinPrep cell production has a more clean background ,more intact cell structure ,more efficient observation and increased posi‐tive rate of detection of cancer cells than the smears made by traditional methods .A combination of two methods can increase the accuracy of cytological detection of fiber bronchoscope aspirates and positive detection rate ,and also can assist the diagnosis of fungi and TB infections .

关 键 词：纤维支气管镜抽吸物 液基细胞制片 细胞学诊断 

分 类 号：R734.2[医药卫生—肿瘤]