传统涂片联合细胞块及免疫细胞化学染色技术诊断浆膜腔积液的应用价值  

Application value of traditional smear combined with cell wax block and immunocytochemistry in the diagnosis of serous cavity effusion

作　　者：范春阳 马丽莉 刘进军 FAN Chunyang;MA Lili;LIU Jingjun(School of Basic Medical Sciences,X′an Jiaotong University,X′an,Shanxi 710000,China;Department of Pathology,the First Affiliated Hospital of Air Force Military Medical University,Xi′an,Shanxi 710032,China)

机构地区：[1]西安交通大学医学部基础医学院,陕西西安710000 [2]空军军医大学第一附属医院病理科,陕西西安710032

出　　处：《现代医药卫生》2023年第14期2429-2432,2437,共5页Journal of Modern Medicine & Health

摘　　要：目的探讨传统涂片联合细胞块及免疫细胞化学染色技术诊断浆膜腔积液,尤其是恶性浆膜腔积液的应用价值。方法收集2022年1-6月空军军医大学第一附属医院病理科接收的浆膜腔积液标本659例,其中胸腔积液416例,腹腔积液221例,心包积液22例;男389例,女270例,年龄11~102岁,中位年龄64岁。分析传统涂片制片方法、细胞块制作、免疫细胞化学染色技术和细胞病理学诊断结果并学习相关文献。结果659例患者中采用单纯传统涂片诊断为良性浆膜腔积液303例(45.98%),恶性浆膜腔积液123例(18.66%),意义不明的、可疑恶性233例(35.36%);659例患者中72例采用传统涂片联合细胞块及免疫细胞化学染色技术,其中诊断为良性浆膜腔积液8例(11.11%)、恶性浆膜腔积液64例(88.89%),并进一步确诊了恶性细胞的组织起源。结论传统涂片联合细胞块及免疫细胞化学染色技术相对于单纯传统涂片不仅能提高阳性标本检出率,还对确定组织来源、确诊肿瘤原发灶有很重要的帮助。Objective To explore the application value of traditional smear combined with cell wax block and immunocytochemistry staining in the diagnosis of serous cavity effusion,especially malignant serous cavity effusion.Methods A total of 659 serous effusion specimens in the Department of Pathology of this hospital were collected,from January 2022 to June 2022,including 416 cases of hydrothorax,221 cases of ascites and 22 cases of pericardial effusion.There were 389 males and 270 females ranging in age from 11 to 102,with a median age of 64.The results of traditional smear preparation,cell block preparation,immunocytochemical staining and cytopathologic diagnosis were analyzed and related literature was studied.Results Among the 659 cases with serosal effusion,303 cases(45.98%)were diagnosed as benign serous effusion,123 cases(18.66%)were diagnosed as malignant serous effusion,and 233 cases(35.36%)were diagnosed as unknown significance and suspected malignancy by traditional smear.Among the 659 cases,72 cases underwent traditional smear combined with cell wax block and immunocytochemistry,eight cases(11.11%)were diagnosed as benign serosal effusion,64 cases(88.89%)were diagnosed as malignant serous effusion,and the tissue origin of malignant cells was further confirmed.Conclusion Compared with the traditional smear method alone,the traditional smear combined with cell wax blocks and immunocytochemical staining can not only improve the detection rate of positive specimens,but also help to determine the origin of the tissue and confirm the primary tumor.

关 键 词：浆膜腔积液 传统涂片 细胞块 免疫细胞化学染色技术 细胞病理学 

分 类 号：R442.5[医药卫生—诊断学] R446[医药卫生—临床医学]