应用EBUS-TBNA细胞块检查对肺癌的诊断价值及临床意义  

The diagnostic value and significance of EBUS-TBNA cells in diagnosis 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]广东省佛山市顺德第一人民医院病理科,广东顺德528300 [2]广东省佛山市顺德第一人民医院呼吸内科,广东顺德528300

出　　处：《现代医学》2016年第6期813-815,共3页Modern Medical Journal

基　　金：佛山市卫生和计生局医学科研课题立项(2015109)

摘　　要：目的:探讨经支气管针吸活检(EBUS-TBNA)细胞块检测对于诊断肺癌的临床价值和意义。方法:回顾性分析2012年1月至2015年5月在我院行EBUS-TBNA检查的173例患者,收集标本,并应用液基细胞学(TCT)及细胞蜡块免疫组化法进行检测,分析在单独应用和联合应用时的敏感性、特异性以及准确性。结果:TCT检测结果阳性率是71.1%(123/173),细胞蜡块检测阳性率是87.28%(151/173),差异有统计学意义(P<0.05);而TCT联合细胞蜡块检测诊断的阳性率则是99.42%(172/173),高于单用细胞蜡块检测阳性率,差异有统计学意义(P<0.05);173例患者最终有172例经病理学确诊为肺癌,TCT敏感性为71.5%、准确性为71.1%,显著低于细胞蜡块免疫组化检测的敏感性87.79%、准确性87.28%,联合诊断敏感性、准确性均为100.0%。结论:通过对EBUS-TBNA取得的细胞块进行蜡块和细胞学的检测,可以有效提高对肺癌的诊断,为肺癌患者及早诊断、治疗赢得了时机。Objective： To discuss the clinical value and significance of detection of EBUS-TBNA cells（ EBUSTBNA） in the diagnosis of lung cancer. Methods： 173 cases of patients with EBUS-TBNA in our hospital from January 2012 to May 2015 were given retrospective analysis,specimen was collected,liquid basis cytology（ TCT）and cell paraffin block immunohistochemical method were used to detect,the sensitivity,specificity and accuracy were analyzed when they were separate application and combined application. Results： The positive rate of TCT detection was 71. 1%（ 123 /173）,and the positive rate of cell wax detection was 87. 28%（ 151 /173）,the difference was significant（ P〈0. 05）,while the combined diagnosis positive rate was 99. 42%（ 172 /173）,with significant differences（ P〈0. 05）. 172 cases of patients were eventually diagnosed as lung cancer by pathological diagnosis among 173 cases of patients,the sensitivity of TCT was 71. 5%,the accuracy was 71. 5%,they were significantly lower than that of the cell wax block（ 87. 79% and 87. 28%）. Sensitivity,accuracy of combined diagnosis were both 100. 0%. Conclusion： The cells taken by EBUS-TBNA are given the detection of paraffin block and cytology,it can effectively improve the diagnosis of lung cancer,and win the opportunity for the early diagnosis and treatment of patients with lung cancer.

关 键 词：经支气管针吸活检术 细胞块 肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]