液基细胞学联合细胞块免疫组化检测对肺癌诊断价值研究  

Diagnostic value of liquid based cytology combined with cell block immunohistochemical stain in detection of lung cancer

作　　者：陈坚平[1] 康凯夫[1] 吴国标[1] 李玺[2] 

机构地区：[1]顺德第一人民医院病理科,广东佛山528300 [2]顺德第一人民医院呼吸内科,广东佛山528300

出　　处：《临床肺科杂志》2016年第1期16-19,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨液基细胞学联合细胞块免疫组化检测在诊断肺癌组织中的应用价值。方法选择2014年7月～12月在我院住院治疗疑似肺癌患者64例为研究对象,采用支气管针吸活检术（TBNA）采集标本,分别进行液基细胞学检测与细胞块免疫组化检测,以病理组织学为金标准,比较两种检测方法、联合检测的诊断效能。结果 64例疑似肺癌患者中,鳞癌33例,腺癌21例,小细胞癌5例,其它2例;细胞块免疫组化灵敏度（91.80%）、准确率（90.63%）、阴性预测值（28.57%）明显高于液基细胞学检测,差异有统计学意义（χ2=4.827～32.916,P〈0.05,P〈0.01）;联合检测灵敏度（98.36%）、准确度（98.44%）、阴性预测值（75.00%）明显高于液基细胞学、细胞块免疫组化单独检测,差异有统计学意义（χ2=4.815～46.964,P〈0.05,P〈0.01）;甲状腺转录因子（TTF-1）在腺癌中阳性表达（91.80%）明显高于鳞癌,细胞角蛋白5/6（CK5/6）、P63在腺癌中的阳性表达（9.84%、3.28%）明显低于鳞癌,比较差异有统计学意义（χ2=42.784～62.694,P〈0.01）。结论液基细胞学联合细胞块免疫组化有助于提高肺癌诊断有灵敏度、准确度,完全可以满足肺癌的早期诊断。Objective To explore the application value of liquid based cytology combined with cell block immunohistochemical stain in the diagnosis of lung cancer. Methods 64 patients with suspected lung cancer were tested by liquid based cytology test and cell block immunohistochemical stain. Pathological histology was taken as the gold standard,the diagnostic value of the two methods was compared. Results 64 patients with suspected lung cancer included 33 cases of squamous carcinoma,20 cases of adenocarcinoma,5 cases of small cell carcinoma,and another 2 cases. For cell block immunohistochemical stain,the sensitivity was 91. 80%,the accuracy was 90. 63%,and the negative predictive value was 28. 57%,which were significantly higher than those of liquid based cytology test（ χ2= 4. 827 ～ 32. 916,P〈 0. 05,P〈 0. 01）. The joint detection sensitivity was 98. 36%,98. 44% for accuracy,and 75% for negative predictive value（ χ2= 4. 815 ～ 46. 964,P〈 0. 05,P〈 0. 01）. The positive expression of TTF-1 in adenocarcinoma was 91. 80%,which was significantly higher than that in squamous cell carcinomas. The positive expression of CK5 /6 and P63 was 9. 84% and 9. 84% in adenocarcinoma,which was significantly lower than those in squamous cell carcinomas（ χ2= 42. 784 ～ 62. 694,P〈 0. 01）. Conclusion Liquid based cytology combined with cell block immunohistochemical stain can improve sensitivity,accuracy,and it can completely meet the early diagnosis of lung cancer.

关 键 词：液基细胞学 免疫组化 肿瘤标志物 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]