浆膜腔积液细胞形态学与细胞病理学诊断恶性积液的价值  

Value of Serous Cavity Effusion Cell Morphology and Cytopathology in the Diagnosis of Malignant Effusion

作　　者：于鸿滨 张连杰 YU Hongbin;ZHANG Lianjie(Suzhou Dushu Lake Hospital,Suzhou 215123,China)

机构地区：[1]苏州市独墅湖医院(苏州大学附属独墅湖医院),江苏苏州215123

出　　处：《中外医学研究》2023年第30期65-68,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较浆膜腔积液细胞形态学与细胞病理学诊断恶性积液的价值。方法:回顾性分析2021年7月—2022年6月苏州市独墅湖医院收治的218例浆膜腔积液患者的临床资料。所有患者进行浆膜腔积液细胞形态学、细胞病理学检测。分析不同原发部位恶性肿瘤浆膜腔积液分布情况。分析浆膜腔积液细胞形态学与细胞病理学诊断一致性。比较细胞形态学和细胞病理学诊断恶性积液的效能。结果:218例浆膜腔积液患者经临床综合诊断恶性积液131例,胸腔积液中最常见的为肺癌,占比为74.16%(66/89),腹腔积液中最常见的为胃癌,占比为27.78%(10/36),其次为肝癌,占比为22.22%(8/36),心包腔积液中最常见的为肺癌,占比为66.67%(4/6)。122例未见肿瘤细胞,1例可疑肿瘤细胞、42例恶性肿瘤细胞,细胞形态学与细胞病理学诊断一致,一致率为75.69%(165/218)。细胞形态学与细胞病理学特异度和误诊率比较,差异无统计学意义(P>0.05);细胞形态学敏感度、准确率均高于细胞病理学,漏诊率低于细胞病理学,差异有统计学意义(P<0.05)。结论:浆膜腔积液细胞形态学在恶性积液的诊断中具有重要价值,可作为细胞病理学强有力的补充。Objective:To compare the value of serous cavity effusion cell morphology and cytopathology in the diagnosis of malignant effusion.Method:The clinical data of 218 patients with serous cavity effusion treated in Suzhou Dushu Lake Hospital from July 2021 to June 2022 were retrospectively analyzed.All patients underwent cell morphology and cytopathological testing for serous cavity effusion.The distribution condition of fluid accumulation in serosal cavity of malignant tumors at different primary sites was analyzed.The diagnosis consistency of serous cavity effusion cell morphology and cytopathology was analyzed.The efficacy of cell morphology and cytopathology in the diagnosis of malignant effusion was compared.Result:Among 218 patients with serosal cavity effusion,131 cases were clinically diagnosed as malignant effusion.Among pleural effusion,the most common was lung cancer,accounting for 74.16%(66/89);among peritoneal effusion,the most common was gastric cancer,accounting for 27.78%(10/36);followed by liver cancer,accounting for 22.22%(8/36).The most common type of pericardial effusion was lung cancer,accounting for 66.67%(4/6).There were 122 cases with no tumor cells,1 case with suspected tumor cells,and 42 cases with malignant tumor cells,the morphologic and cytopathological diagnoses were consistent with 75.69%(165/218).There were no significant differences in the specificity and misdiagnosis rate of cell morphology and cytopathology(P>0.05).The sensitivity and accuracy of cell morphology were higher than that of cytopathology,and the rate of missed diagnosis was lower than that of cytopathology,the differences were statistically significant(P<0.05).Conclusion:The cell morphology of serous cavity effusion has important value in the diagnosis of malignant effusion and can serve as a powerful supplement to cellular pathology.

关 键 词：浆膜腔积液 细胞形态学 细胞病理学 恶性积液 

分 类 号：R446.1[医药卫生—诊断学]