细胞学快速现场评价在肺癌诊断中的应用价值  

The value of rapid on site evaluation of cytology on the diagnosis of lung carcinoma

作　　者：刘蓉 王亚霓 史维晨 王新峰[1] 刘伟[1] 胡建功[1] Liu Rong;Wang Yani;Shi Weichen;Wang Xinfeng;Liu Wei;Hu Jiangong(The Second Affiliate Hospital of Tianjin TCM,Tianjin 300250,China)

机构地区：[1]天津中医药大学第二附属医院,天津300250

出　　处：《首都食品与医药》2023年第15期37-39,共3页Capital Food Medicine

摘　　要：目的 探讨细胞学快速现场评价(rapid on site evaluation,ROSE)在肺癌诊断中的意义.方法 收集2017年1月-2022年11月胸部CT表现为肺占位性病变或纵膈淋巴结肿大行超声支气管镜(endobronchial ultrasound,EBUS)活检的246例病例,对其术中送检细胞学涂片行ROSE检查并留取活检组织,由2名病理医师进行结果判读.分析ROSE判读结果与后续进行的组织病理学检查结果的一致性,并以同期行支气管镜活检的51例普通细胞学诊断(General cytological diagnosis,GCD)标本作为对照,比较两组在诊断敏感度、特异度及诊断准确率方面的差异.结果 ROSE组病例中182例为恶性肿瘤,64例为良性病变.恶性肿瘤包括鳞癌68例,腺癌47例,小细胞癌55例,其他组织学类型12例.ROSE组诊断灵敏度为93.96%,高于GCD组(χ^(2)=7.897,P<0.01);特异度及诊断准确率分别为87.50%和92.28%,与GCD组相比,差异无显著性(均P>0.05).一致性检验提示ROSE与病理组织学活检结果具有较好的一致性(κ=0.802,P<0.01).结论 ROSE灵敏度、特异度、准确率均较高,有助于内镜医师及时修正活检取材部位及方式,提高恶性肿瘤检出率,可常规应用于EBUS活检.Objective To investigate the value of rapid on-site evaluation(ROSE)of cytology on the diagnosis of lung carcinoma.Methods A total of 246 cases with chest CT findings of lung neoplasms and mediastinal adenopathy underwent endobronchial ultrasound were collected from January 2017 to November 2022.The cytological smears submitted from intraoperative examination were performed a ROSE check and biopsy tissue was carried out routinely.Two pathologists interpreted the results.This study retrospectively analyzed the consistency of ROSE and the subsequent histopathological examination,and 51 general cytological diagnosis(GCD)cytological specimens that underwent bronchoscopy biopsy concurrently were selected as the control group to compare the differences in diagnostic sensitivity,specificity and accuracy.Results 182 cases were malignancy in ROSE group,including 68 cases of squamous cell carcinoma,47 cases of adenocarcinoma,55 cases of small cell carcinoma and 12 cases of other types,as well as 64 cases were benign lesions.The sensitivity of ROSE was 93.96%,which was much higher than that of GCD group(χ^(2)=7.897,P<0.01).The specificity and accuracy of ROSE were 87.50%and 92.28%respectively.No significance was found compared with GCD group(P>0.05).Consistency check indicated that ROSE was in good consistency with histopathological biopsy results(κ=0.802,P<0.01).Conclusion ROSE is high sensitivity,specificity and accuracy in the diagnosis of lung cancer,and may be used in endobronchial ultrasound biopsy routinely,which will be beneficial to modify the biopsy site and method in time and improve the detection rate of malignant tumors.

关 键 词：快速现场评价 超声支气管镜 细胞学 肺癌 

分 类 号：R730.2[医药卫生—肿瘤]