肺癌高危患者不同标本液基细胞学检查的临床意义  

Clinical Significance of Lung Cancer in High-risk Patients with Different Specimens of Liquid-based Cytology

作　　者：于健健 王珺[2] 陈玉娟[2] 姜琪娜[2] 张晓野[2] YU Jian-jian;WANG Jun;CHEN Yu-juan;JIANG Qi-na;ZHANG Xiao-ye(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学中医学院,济南250014 [2]山东中医药大学第二附属医院,济南250001

出　　处：《科学技术与工程》2018年第26期171-175,共5页Science Technology and Engineering

摘　　要：探讨液基细胞学检查(LCT)技术在痰、胸水、纤维支气管镜毛刷标本的肺癌检测方面较传统细胞涂片(CS)的优势,评估LCT是否有助于肺癌的早期诊断。选择359例肺癌高危患者为研究对象,将痰、胸水、纤维支气管镜毛刷标本分为LCT组、CS组。采用3级分类诊断法诊断LCT组和CS组,将细胞学检查结果分为阴性、阳性(可疑恶性和恶性)。采用筛检、诊断试验分析方法,计算灵敏度、特异度、假阳性率(误诊率)、假阴性率(漏诊率)、一致率及约登指数。不同组别采用Riddit分析方法进行比较;并分析两种方法的涂片质量和检出的癌细胞的形态结构。两种不同方法筛查三种来源标本肺癌细胞结果的比较如下:(1)灵敏度:LCT组灵敏度均高于CS组(P<0.01),差异有统计学意义。(2)特异度:LCT组与CS组差异无统计学意义(P=0.325)。(3)一致率:LCT组明显高于CS组(P<0.01),差异有统计学意义。(4)假阴性率:痰、胸水、纤支镜毛刷标本LCT组筛查肺癌的假阴性率低于CS组。(5)假阳性率:痰、纤支镜毛刷标本LCT组筛查肺癌的假阳性率低于CS组,胸水LCT组筛查肺癌的假阳性率高于CS组。(6)LCT组在涂片质量、癌细胞形态学判断方面较CS组好。说明液基细胞学检测技术对肺癌的诊断价值高于传统细胞学检测,可降低肺癌的误诊率及漏诊率,具有重要的临床应用价值。To explore the advantage of liquid-based cytology test(LCT)in the detection of lung cancer in sputum,pleural fluid and bronchoscopy brush specimen,compared with conventional smear(CS),and to evaluate whether LCT is helpful for early diagnosis of lung cancer,359 patients with high risk of lung cancer were selected as the research subjects.Sputum,pleural fluid and bronchoscopy brush specimens were divided into group LCT and group CS.The 3 class classification diagnosis method was used to diagnose the LCT group and the CS test group,and the results of cytology examination were divided into negative and positive(suspected malignant and malignant).The methods of screening and diagnostic tests were used to calculate the sensitivity,specificity,false positive rate(misdiagnosis rate),false negative rate(missed diagnosis rate),the rate of agreement and Youden index.The Riddit analysis method was used to compare the different groups,and the smear quality and the morphology and structure of the cancer cells detected by the two methods were analyzed.Comparison of two different methods for screening lung cancer cells from three sources is as follows.①Sensitivity:the sensitivity of LCT group was higher than that of CS group(P<0.01),the difference was statistically significant.②Specificity:there was no significant difference between LCT group and CS group(P=0.325).③Consistency rate:the consistency rate of LCT group was significantly higher than that of CS group(P<0.01),the difference was statistically significant.④False negative rate:for sputum,pleural fluid and fiberoptic bronchoscopy brush specimens,the false negative rate of lung cancer screening based on LCT group is lower than that of CS group.⑤False positive rate:for sputum and bronchoscopic brush specimens,the false positive rate of lung cancer screening in the LCT group was lower than that of the CS group.The false positive rate of lung cancer by the hydrothorax based LCT group was higher than that of the CS group.⑥The LCT group was better than the CS group

关 键 词：液基细胞学检测 传统细胞学检测 肺癌 诊断 

分 类 号：R446.1[医药卫生—诊断学]