液基薄层细胞学与组织学在超声支气管镜获取标本诊断中的作用  

SureP ath liquid-based cytology test and histopathology in diagnosis of endobroncheal ultrasonography-guided transbronchial needle aspiration samples

作　　者：邹俊勇[1] 黄春鑫 潘登 赵伟和[1] 陈静璐[1] 蔡挺[1] 

机构地区：[1]宁波市第二医院呼吸内科,315010 [2]宁波市临床病理诊断中心病理科

出　　处：《浙江医学》2016年第12期952-955,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2016KYB267);浙江省自然基金资助项目(LY13H190008);宁波市社发择优基金资助项目(2011C51002)

摘　　要：目的探讨液基薄层细胞学(LCT)与组织病理学(HP)在支气管镜超声引导下经支气管壁针吸活检术(EBUS-TBNA)获取纵隔标本诊断中的应用价值。方法收集行EBUS-TBNA检查的连续病例49例。获取细胞学标本49例,组织学标本46例,分别采用LCT及HP技术进行病理诊断,并对LCT与HP单独及联合诊断的敏感度与特异度进行比较。结果在49例中,两种诊断技术最终确诊46例:肺癌32例,恶性淋巴瘤2例,淋巴结核2例,结节病2例,气管旁机化性肺炎1例,支气管旁肺脓肿1例,反应性淋巴结增生6例。3例未确诊病例,最后通过手术确诊均为肺癌。35例肺癌病例中:LCT确诊31例,敏感度88.57%;HP确诊23例,敏感度65.71%;两种技术联合确诊32例,敏感度91.43%。特异度均为100%。两种病理技术诊断敏感度比较差异无统计学意义(P>0.05),但LCT、HP与联合诊断敏感度比较差异均有统计学意义(P<0.05或0.01)。49例中,LCT确诊41例,敏感度83.67%;HP确诊37例,敏感度75.51%;两种技术联合确诊46例,敏感度93.88%,特异度均为100.00%。两种病理技术诊断敏感度比较差异无统计学意义(P>0.05),但LCT、HP与联合诊断敏感度比较差异均有统计学意义(P<0.05或0.01)。结论在使用EBUS-TBNA获取标本的肺癌病例以及49例病例中,联合应用LCT及HP均能提高诊断的敏感度。Objective To assess the SurePath Liquid- based Cytology Test （LCT） and histopathology （HP） in diagnosis endobroncheal ultrasonography- guided transbronchial needle aspiration （EBUS- TBNA） samples. Methods Forty nine sequential patients undergoing EBUS- TBNA were included in the study. LCT and HP examination were performed in 49 cel specimens and 46 tissue specimens. The diagnostic sensitivity and specificity of single or combination of two methods were compared. Results Among 46 cases, there were 32 cases of lung cancer, 2 cases of sarcoidosis, 2 cases of lymphoid tuberculosis, 2 cases of lymphoma, 1 case of organized pneumonia near trachea, 1 case of lung abscess near bronchus, 6 cases of reactive lymph node hyperplasia;in the undiagnosed 3 cases, lung cancer was confirmed through surgery. In these 35 lung cancer cases, sensitivity and specificity of LCT were 88.57%and 100.0%, those of HP were 65.71%and 100.0%, and those of combination of two methods were 91.43%and 100.0%.The combination of two methods had a significant higher diagnostic sensitivity in lung cancer than LCT （P〈0.01）or HP （P〈0.05）. The overal sensitivity and specificity of LCT were 83.67%and 100.0%, those of HP was 75.51%and 100.0%, and those of combination were 93.88%and 100.0%.Combination of two methods also had a significant higher diagnostic sensitivity than LCT （P〈0.01）or HP （P〈0.05）. There was no statistical y significant difference between LCT and HP in diagnostic sensitivity of lung cancer patients （P〉0.05）or of all patients （P〉0.05）. Conclusion The study shows that the combination of LCT and HP can increase diagnostic sensitivity of samples obtained from EBUS- TBNA.

关 键 词：液基细胞学 组织病理技术 超声支气管镜 肺癌 纵隔 

分 类 号：R734.2[医药卫生—肿瘤]