巴氏染色联合苏木精-伊红染色在甲状腺穿刺液基细胞学诊断中的应用  

Papanicolaou staining combined with hematoxylin-eosin staining for thyroid liquid-based cytological diagnosis of thyroid lesions

作　　者：张永生 高萍 张立平 王萍萍 韩洁 李强 Zhang Yongsheng;Gao Ping;Zhang Liping;Wang Pingping;Han Jie;Li Qiang(Department of Pathology,Rizhao Central Hospital,Rizhao 276800,Shandong Province,China)

机构地区：[1]日照市中心医院病理科,山东省276800

出　　处：《中国基层医药》2021年第1期85-89,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨巴氏染色联合苏木精-伊红染色在甲状腺穿刺液基细胞学诊断中的应用价值。方法:选取日照市中心医院2018年1月至2020年1月超声引导下细针穿刺细胞学检查的甲状腺结节标本476例,均通过手术获得术后组织病理诊断结果,细胞涂片使用液基细胞学技术进行沉降型制片(LCT),每份标本同时制片2张,分别进行巴氏染色及苏木精-伊红染色。将阅片结果分为三组,分别为巴氏染色组、苏木精-伊红染色组、巴氏染色联合苏木精-伊红染色组(联合染色组),三组分别依据甲状腺细胞学Bethesda报告系统诊断分类进行统计分析并与组织病理学结果进行对比分析。结果:三组按细胞学诊断分类结果进行对比分析,其恶性结节检出率分别为巴氏染色组65.5%(312/476)、苏木精-伊红染色组64.1%(305/476)、联合染色组74.4%(354/476),联合染色组恶性结节检出率高于另外两组,均差异有统计学意义(χ^(2)=8.816、11.838,均P<0.05)。液基细胞学检查结果与术后组织病理符合率,巴氏染色组91.2%(434/476)、苏木精-伊红染色组90.5%(431/476)、联合染色组95.8%(456/476)。联合染色组细胞学与组织病理检查符合率均高于另外两组(χ^(2)=8.350、10.320,均P<0.05)。结论:甲状腺结节细针穿刺液基细胞学沉降型制片巴氏染色联合苏木精-伊红染色在甲状腺穿刺细胞学诊断中可提高恶性结节检出率及诊断正确率。Objective To investigate the application value of papanicolaou staining combined with hematoxylin-eosin staining for thyroid liquid-based cytological diagnosis of thyroid lesions.Methods Thyroid nodules of 476 patients who received ultrasound-guided fine-needle aspiration cytology from January 2018 to January 2020 in Rizhao Central Hospital were collected for this study.Histopathological diagnosis of these thyroid nodules was obtained after surgery.Two cell smears per specimen were made by liquid-based cytology technology and then stained with papanicolaou and hematoxylin-eosin,respectively.Staining results were divided into three groups according to different staining methods used:papanicolaou,hematoxylin-eosin,papanicolaou+hematoxylin-eosin.After statistical analysis with the Bethesda system for reporting thyroid cytopathology,staining results were compared with histopathological results.Results Cytopathological analysis revealed that the detection rate of malignant nodules was 65.5%(312/476)in the papanicolaou group,64.1%(305/476)in the hematoxylin-eosin group and 74.4%(354/476)in the papanicolaou+hematoxylin-eosin group.The detection rate of malignant nodules in the papanicolaou+hematoxylin-eosin group was significantly higher than that in the other two groups(χ^(2)=8.816,11.838,both P<0.05).The coincidence rate of thyroid liquid-based cytological diagnosis and postoperative histopathology was 91.2%(434/476)in the papanicolaou group,90.5%(431/476)in the hematoxylin-eosin group and 95.8%(456/476)in the papanicolaou+hematoxylin-eosin group.The coincidence rate of thyroid liquid-based cytological diagnosis and postoperative histopathology in the papanicolaou+hematoxylin-eosin group was significantly higher than that in the other two groups(χ^(2)=8.350,10.320,both P<0.05).Conclusion Thyroid liquid-based cytology with papanicolaou staining combined with hematoxylin-eosin staining can increase the detection rate and diagnostic accuracy of malignant thyroid nodules.

关 键 词：染色与标记 活组织检查 针吸 组织细胞学制备技术 染色质免疫沉淀法 甲状腺疾病 甲状腺结节 诊断 病理学 临床 

分 类 号：R446.8[医药卫生—诊断学] R581[医药卫生—临床医学]