RICC应用于乳腺癌术中腋窝前哨淋巴结印片检查的可行性研究  

Feasibility of RICC in the inoperative axillary sentinel lymph node cytological smear examination for breast cancer

作　　者：陈伟 岳会珠 杨五松 CHEN Wei;YUE Huizhu;YANG Wusong(Pathology Department,Fangcheng County People's Hospital,Nanyang,Henan 473200,China;Pathology Department,Nanyang South Stone Hospital,Nanyang,Henan 473200,China)

机构地区：[1]方城县人民医院病理科,河南南阳473200 [2]南阳南石医院病理科,河南南阳473200

出　　处：《社区医学杂志》2024年第11期389-393,共5页Journal Of Community Medicine

摘　　要：目的探究快速免疫细胞化学技术(RICC)应用于乳腺癌术中腋窝前哨淋巴结(SLN)细胞学印片(TIC)的可行性及对诊断效能的影响。方法选取2022-02-01-2023-06-01方城县人民医院行乳腺癌改良根治术且术中行SLN活体组织学检查的100例患者的SLN活体组织学样本,所有SLN组织样本均进行TIC检查及RICC检查,RICC检测以广谱细胞角蛋白19(pan-CK19)为标志物。乳腺癌腋窝SLN的转移结果以术后石蜡切片的组织学检查结果作为金标准,采用独立样本的t检验比较单独TIC检查及TIC联合RICC检查诊断所需时间,参照金标准采用四表格χ^(2)检验分析TIC检查及TIC联合RICC检查诊断乳腺癌腋窝SLN的转移的价值,并采用灵敏度、特异度、准确度、阳性预测值及阴性预测值分析诊断效能。结果单独TIC检测的诊断时间为(9.14±1.18)min,TIC联合RICC检测的诊断时间为(13.96±1.23)min,TIC联合RICC检测时间长于单独TIC检测,t=28.278,P<0.001;单独TIC检测共检出阳性18例,其中真阳性16例,假阳性2例;阴性82例,其中真阴性71例,假阴性11例;RICC和TIC联合检测共检出阳性28例,其中真阳性25例,假阳性3例;阴性72例,真阴性70例,假阴性2例。单独TIC检测的特异度、阳性预测值分别为97.26%、88.89%,TIC联合RICC检测分别为95.89%、89.29%,差异无统计学意义,χ^(2)值分别为0.207和0.002,P值分别为0.649和0.966;TIC联合RICC检测的灵敏度为92.59%、准确度为95.00及阴性预测值为97.22%显著高于单独TIC检测59.26%、87.00%、86.59%,差异有统计学意义,χ^(2)值分别为8.206、3.907和5.612,P值分别为0.004、0.048和0.018。结论RICC应用于乳腺癌术中腋窝SLN的TIC检查中,可明显提升其灵敏度、准确度、阴性预测值等诊断效能指标,且术中诊断所用时间同样较短,具有较高的可行性。Objective To explore the feasibility and effect of rapid immunocytochemical technique(RICC)on axillary sentinel lymph node(SLN)touch imprint cytology(TIC)examination in breast cancer operation.Methods From February 1,2022 to June 1,2023,100 patients who underwent modified radical mastectomy and underwent SLN biopsy in Fangcheng County People's Hospital were collected.All SLN biopsy samples were examined by TIC and RICC,and the RICC detection was marked by pan-CK19.The metastatic results of breast cancer axillary SLN were based on the histological examination results of paraffin sections after operation.The independent samples t-test of independent samples was used to compare the time required for diagnosis of TIC alone and TIC combined with RICC.According to the gold standard,the four-tableχ^(2)test was used to analyze the value of TIC examination,RICC examination and TIC combined with RICC examination in diagnosing breast cancer axillary SLN metastasis,and the sensitivity,specificity positive predictive value,and negative predictive value were used to analyze the diagnostic efficiency.Results The diagnostic time of TIC alone was(9.14±1.18)min,and that of TIC combined with RICC was(13.96±1.23)min,which was longer than that of TIC alone(t=28.278,P<0.001).There were 18 positive cases detected by TIC alone,including 16 true positive cases and 2 false positive cases.Eighty-two cases were negative,including 71 true negative cases and 11 false negative cases;A total of 28 cases were detected by RICC and TIC,including 25 true positive cases and 3 false positive cases;72 cases were negative,70 cases were true negative and 2cases were false negative.The specificity and positive predictive value of TIC alone were 97.26%and 88.89%,and that of TIC combined with RICC was 95.89%and 89.29%,respectively,with no statistical significance(χ^(2)=0.207,P=0.649;χ^(2)=0.002,P=0.966),the sensitivity,accuracy and negative predictive value of the combined detection of TIC and RICC were 92.59%,95.00%and 97.22%,which were significantly

关 键 词：乳腺癌 前哨淋巴结 细胞学印片 快速免疫细胞化学技术 

分 类 号：R737.9[医药卫生—肿瘤]