痰脱落细胞涂片结合TCT、痰沉渣琼脂石蜡双包埋片法在肺癌高危人群筛查诊断中的应用  

Application of sputum exfoliated cells smear combined with TCT, sputum sediment AGAR paraffin double embedding method in screening and diagnosis of high risk group with lung cancer

作　　者：林淑端 郭智俊[2] 陈石桥 潘啟森 黄倩萍 姜山 吴业辉 

机构地区：[1]广东省佛山市南海经济开发区人民医院,广东佛山528234 [2]广东省佛山市南海区第二人民医院,广东佛山528200

出　　处：《中国医药科学》2015年第14期156-158,173,共4页China Medicine And Pharmacy

基　　金：广东省佛山市卫生和计生局医学科研课题(2015026)

摘　　要：目的 探讨痰脱落细胞涂片结合膜式超薄液基细胞学检测（thin-prep cytology test,TCT）技术、痰沉渣琼脂石蜡双包埋片法（sputum sediment AGAR paraffin double embedding method,APSM）在肺癌高危人群筛查诊断中的应用价值。方法 选取2014年1月~2015年6月南海经济开发区人民医院呼吸内科、居民健康体检及工厂体检可疑肺癌患者（吸烟史、胸部影像学检查阳或阴,临床症状有咳痰咯血）189例,分别进行痰脱落细胞涂片结合TCT与APSM检查,然后再行TCT与APSM细胞学比较分析。结果 在189例疑似肺癌患者痰液标本中,自荧光支气管镜（AFB）技术和手术切除标本病理组织学检查确诊为肺癌179例占94.71%（179/189）。痰脱落细胞涂片、TCT及痰沉渣琼脂石蜡双包埋片法检测肺癌细胞结果之间相比较（P均〉0.05）,痰脱落细胞涂片结合TCT、痰沉渣琼脂石蜡双包埋片法检测肺癌细胞检出阳性率为97.21%显著地高于TCT结合痰沉渣琼脂石蜡双包埋片法的84.92%（P〈0.05）。结论 运用子宫颈脱落细胞学诊断的TCT技术、胸腹水细胞学检查APSM检查技术联合应用于痰脱落细胞中,减少因取材的重复性、延期诊断等给患者带来的生活压力,旨在提高阳性诊断率,进而达到早期发现、诊断、治疗,减少由于迟后诊断带来的肺癌的死亡率。Objective To explore the application value of sputum exfoliated cells smear combined with ThinPrep cytology test （TCT） and sputum sediment AGAR paraffin double embedding （APSM） method in screening and diagnosis of high risk group with lung cancer. Methods 189 suspected patients with lung cancer （history of smoking, chest imaging examination positive or negative, clinical symptoms with expectoration and hemoptysis） who were from department of respiration medicine of Nanhai economic development zone People＇s Hospital, resident＇s physical examination and factory physical examination from January 2014 to June 2015 were examined with sputum exfoliated cells smear combined with TCT and APSM, and then cytology of TCT and APSM were compared and analyzed. Results In the sputum specimen of 189 suspected patients with lung cancer, 179 patients were confirmed as lung cancer by auto fluorescence bronchoscope （AFB） technology and histopathologic examination of surgical specimens, which accounted for 94.71% （179/189）. Examination results of sputum exfoliated cells smear, TCT and APSM were compared （P 〉 0.05）. Positive rate of lung cancer cell that tested by sputum exfoliated cells smear and APSM was 97.21%, which was significantly higher than 84.92% that tested by TCT combined with APSM （P 〈 0.05）. Conclusion Application of TCT of detachment of cervix cytodiagnosis combined with APSM of pleural and ascitic fluid cytodiagnosis in sputum exfoliated cells can alleviate patients＇ life pressure from repeated drawing materials and delayed diagnosis to improve positive diagnostic rate and achieve early detection, diagnosis and treatment, so as to decrease the mortality rate of lung cancer due to delayed diagnosis.

关 键 词：痰细胞学 TCT 痰沉渣切片法 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]