TBNA联合Cell-block技术在纵隔淋巴结/肿块诊断中的运用  

Application of TBNA combined with cell-block technique in diagnosis of mediastinal lymph node/tumor

作　　者：陈石[1] 孙怡[2] 朱际平[1] 王谦[1] 魏瑜[1] 周贤梅[1] 

机构地区：[1]江苏省中医院呼吸科,江苏南京210029 [2]江苏省中医院病理科,江苏南京210029

出　　处：《临床肺科杂志》2017年第11期2074-2077,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨支气管镜引导针吸活检术(TBNA)联合cell block(细胞块)技术在纵隔淋巴结/肿块诊断中的运用价值。方法通过选择2016年1月-2016年10月在我院住院治疗疑似肺癌患者80例作为研究对象,采用TBNA采集标本,分别进行取样细胞涂片检测与cell block制片及免疫组化检测,所有患者均通过肺穿刺/TBNA取得组织学病理结果作为金标准,比较两种细胞学检测方法诊断优劣。结果在80例疑似肺癌患者中,组织病理学确诊72例(腺癌35例,鳞癌24例,小细胞癌12例,其它1例)。我们通过常规TBNA细胞学检出41例,TBNA联合Cell block技术组检出56例。常规TBNA细胞学检测敏感性、阴性预测值、准确性分别为56.9%、20.5%、61.3%;Cell block免疫组化检测敏感性、阴性预测值、准确性分别为77.8%、33.3%、80.0%。TBNA联合Cell block技术组免疫组化检测敏感性、阴性预测值、准确性明显高于常规TBNA细胞学检测方法,差异有统计学意义(P<0.05)。结论 TBNA联合Cell-block技术可以提高TBNA对肺癌诊断的灵敏度以及准确度,值得临床推广运用。Objective To investigate the bronchoscope guided transbronchial needle aspiration （ TBNA ） combined with cell block （ cell block） technology in diagnosis of mediastinal lymph node/ tumor. Methods From January 2015 to October 2016, 80 patients were recruited as the research object who suspected with lung cancer in our hospital by using TBNA sampling. Cell smears and cell block sectioning and immunohistochemical detection. The lung biopsy pathology results of all patients were taken as the gold standard, and then the advantages and disadvanta-ges of the two methods were compared. Results In all 80 cases who was suspected with lung cancer, 72 cases were finally diagnosed （35 cases of adenocarcinoma, 24 cases of squamous cell carcinoma, 12 cases small cell carcinoma, 1 other case） . 41 patients were diagnosed by cytology which obtained by conventional TBNA. At the same time, 56 cases were diagnosed by cytology which obtained by conventional TBNA and treated with cell block. The sensitivity, negative predictive value and accuracy were 56. 9%, 20. 5%, 61. 3% in these cases detected by conventional TB-NA, and in these cases which detected by cell block, their sensitivity, negative predictive value and accuracy raised to 77. 8%, 33. 3%, 80. 0% . TBNA combined with cell block technology had a significantly higher detection sensi-tivity, negative predictive value, accuracy than conventional TBNA method did （ P〈0. 05 ） . Conclusion TBNA combined with cell-block can improve the sensitivity and accuracy of TBNA technique for the diagnosis of lung cancer.

关 键 词：细胞块 支气管镜引导针吸活检术 肺癌 免疫组化 

分 类 号：R734.2[医药卫生—肿瘤]