薄层液基细胞学检测法与常规细胞学检测法在恶性胸腔积液诊断中的价值  

Diagnostic Value of Thin-Cytological Test and Routine Cytological Detection for Patients

作　　者：闫崴[1] 朱翔[2] 贺蓓[1] 韩翔[1] 

机构地区：[1]北京大学第三医院呼吸内科,北京100083 [2]北京大学基础医学院病理学系,北京100083

出　　处：《武汉大学学报（医学版）》2015年第6期926-929,共4页Medical Journal of Wuhan University

摘　　要：目的:比较常规细胞学检测法和薄层液基细胞学检测法(TCT)对恶性胸腔积液的诊断价值,旨在为临床应用提供依据。方法:收集89例北京大学第三医院已明确诊断恶性胸腔积液的住院病人胸腔积液标本,分别行细胞涂片和显微镜检;细胞涂片加沉渣包埋、切片并且显微镜检;标本离心后TCT检测。结果:用10ml胸腔积液仅做细胞涂片时敏感性为69.7%;用细胞涂片加沉渣包埋法,30ml胸腔积液时的敏感性达77.5%,增加至60ml时敏感性仍为77.5%;而TCT法敏感性可达84.3%,但以上4种方法的敏感性差异无统计学意义。结论:30ml细胞涂片加沉渣包埋法可获得良好的诊断率,新兴的TCT方法虽然可能更敏感,但其费用高,且无法进行后续的免疫组化等检测,使其应用价值受限。Objective：To compare the results of routine cytological test and thin-cytological test（TCT）in malignant pleural effusion diagnosis.Methods：A total of 89 hospitalized patients with malignant pleural effusion in Peking University Third Hospital were included in this study.To find out malignant tumor cells,samples of pleural effusion were collected for the following examinations：（1）cell smear and microscopy examination;（2）cell smear and embedding,sectioning then microscopy examination;and（3）TCT under the assistance of centrifugal technology.Results：Using only cell smear and microscopy in 10 ml sample,the sensitivity rate of test for tumor cells in pleural suffusion was 69.7%.Using cell smear plus embedding,sectioning and microscopy examination,the sensitivity rate was 77.5%,while increasing the sample to 60 ml,the sensitivity rate was still 77.5%.The sensitivity rate of TCT in 50 ml sample could reach 84.3%,while the above 4sensitivity rates did not show statistically significance.Conclusion：A good diagnostic rate can be made in 30 ml pleural effusion using smear and sediments test,increasing sample volumemade no contribution to increasing diagnostic rate.TCT might reach a higher diagnostic rate,however the method costs more,and the immunohistochemistry analysis can not be conducted subsequently,which limits the clinic practice.

关 键 词：恶性胸腔积液 细胞学检测 薄层液基细胞学检测 细胞涂片 

分 类 号：R730.43[医药卫生—肿瘤]