细胞块石蜡包埋切片与细胞涂片在良恶性胸腹腔积液鉴别中的临床效果对比  

Comparison of clinical efficacy between paraffin-embedded section of cell block and cell smear in differentiating benign and malignant pleural and peritoneal effusion

作　　者：王小莉 WANG Xiaoli(Department of Pathology,Hu'nan Provincial People's Hospital,Changsha410002,China)

机构地区：[1]湖南省人民医院病理科,湖南长沙410002

出　　处：《中国现代医生》2020年第31期134-137,共4页China Modern Doctor

摘　　要：目的探讨细胞块石蜡包埋切片和细胞涂片在良、恶性胸腹腔积液鉴别诊断中的应用价值,探寻提升肿瘤诊断水平的制片方式。方法选取2018年5月~2020年5月在我院就诊的胸腹腔积液患者110例为研究对象,采集其胸腹腔积液标本,制备石蜡包埋切片及细胞涂片,采取双盲法阅片,比较两种诊断方式在恶性胸腹腔积液诊断中的阳性率。结果病理学诊断结果提示,70例胸腔积液的标本中,恶性胸腔积液39例,良性胸腔积液31例;40例腹腔积液标本中,恶性腹腔积液27例,良性腹腔积液13例。细胞块石蜡包埋切片在恶性胸腔积液诊断中的阳性率为79.49%,明显高于细胞涂片的58.97%,差异有统计学意义(P<0.05);细胞块石蜡包埋切片在恶性腹腔积液诊断中的阳性率为81.48%,明显高于细胞涂片的62.96%,差异有统计学意义(P<0.05);细胞块石蜡包埋切片在恶性胸腹腔积液诊断中的准确度、灵敏度及特异度均高于细胞涂片,差异有统计学意义(P<0.05);两种诊断方式的组织学分型中均以腺癌发生率最高,分别为81.13%、75.00%。结论细胞块石蜡包埋切片在良、恶性胸腹腔积液诊断中的应用价值高,与细胞涂片相比,具有更高的阳性率,且灵敏度、特异度和准确度均较高,是细胞学诊断和鉴别良、恶性胸腹腔积液较好的制片方式。Objective To investigate the application value of paraffin-embedded section of cell block and cell smear in the diagnosis and differentiation of benign and malignant pleural and peritoneal effusion and investigate the section making method to improve the diagnostic level of tumor.Methods A total of 110 patients with pleural and peritoneal effusion admitted to our hospital from May 2018 to May 2020 were selected as the research objects,and samples of pleural and peritoneal effusion and peritoneal effusion were collected,paraffin embedded sections and cell smears were prepared,which were read by double-blind method,and the positive rates of the two diagnostic methods in the diagnosis of malignant pleural and peritoneal effusion were compared.Results Pathological diagnosis showed that among 70 samples of pleural effusion,there were 39 cases of malignant pleural effusion and 31 cases of benign pleural effusion.Among 40 samples of peritoneal effusion,there were 27 cases of malignant peritoneal effusion and 13 cases of benign peritoneal effusion.The positive rate of paraffin section of cell block in the diagnosis of malignant pleural effusion was 79.49%,which was significantly higher than 58.97%of cell smear,and the difference was statistically significant(P<0.05).The positive rate of paraffin section of cell block in the diagnosis of peritoneal effusion was 81.48%,which was significantly higher than 62.96%of cell smear,and the difference was statistically significant(P<0.05).The accuracy,sensitivity and specificity of paraffin section in the diagnoses of malignant pleural and peritoneal effusion were higher than those of cell smear,and the differences were statistically significant(P<0.05).The incidence of adenocarcinoma was the highest in the histological classification of the two diagnostic methods,which were 81.13%and 75.00%,respectively.Conclusion The paraffin embedded section of cell block has high application value in the diagnosis of benign and malignant pleural and peritoneal effusion.Compared with cell smear,

关 键 词：胸腹腔积液 良、恶性鉴别 细胞块石蜡包埋切片 细胞涂片 

分 类 号：R561[医药卫生—呼吸系统]