荧光ROSE在肺恶性肿瘤细胞学诊断中的应用分析  

Analysis of fluorescence ROSE in cytological diagnosis of lung malignant tumors

作　　者：刘加夫 张宏英 陈晓红 林清华 陈友轩 吴联平 林玉琼 黄小红 LIU Jiafu;ZHANG Hongying;CHEN Xiaohong;LIN Qinghua;CHEN Youruan;WU Lianping;LIN Yuqiong;HUANG Xiaohong(Fuzhou Pulmomary Hospital,Fuzhou,Fujian 350008,China)

机构地区：[1]福建省福州肺科医院,福州350008

出　　处：《福建医药杂志》2024年第4期6-9,F0003,共5页Fujian Medical Journal

基　　金：福州市科技局市级科技计划项目(2021-S-255)。

摘　　要：目的探讨在CT引导经皮肺活检(PTLB)联合荧光细胞学现场快速评估(F-rose)在肺恶性肿瘤细胞学诊断中的应用价值。方法收集在我院进行的微创CT引导下经皮肺穿刺活检的住院患者120例。在CT引导定位下对病变区域细针穿刺取材,将穿刺针残留液涂至两张载玻片上,并分别用另两张清洁载玻片叠放、轻压,反向匀速拉开,制成4张涂片,迅速放置于95%酒精中固定后取出干燥。通过荧光ROSE染色和ROSE染色来评估两种染色方法在肺部占位性病变中的差异性。根据组织病理学结果明确病理诊断筛选出94例患者,其中确诊恶性肿瘤66例,非肿瘤性病变28例。患者以真菌和抗酸分枝杆菌阳性为非肿瘤性病变患者。以病理组织学结果为金标准,分析两种方法对肺恶性肿瘤细胞学诊断的灵敏度及特异度,并评估两种方法对肺恶性肿瘤的细胞学诊断价值差异性。结果荧光ROSE和ROSE组的总确诊率分别为60.64%和48.94%(P<0.05);诊断肺部恶性肿瘤的灵敏度两组均为68.18%(P>0.05);荧光ROSE和ROSE组的特异度分别为42.86%、3.57%(P<0.05)。结论荧光ROSE联合PTLB可提高肺部占位性病变的确诊率,尤其可提高肺部恶性肿瘤细胞学诊断的特异度,在肺部占位性病变细胞学诊断中具有一定临床应用价值。Objective To explore the clinical application of CT-guided percutaneous lung blopsy(PTLB)combined withfluorescence cytology rapid on-site evaluation(F-rose)in the cytological diagnosis of lung malignant tumors.Methods One hun-dred and twenty hospitalized patients who underwent minimally invasive CT-guided percutaneous lung puncture biopsy in ourhospital were collected.Under CT-guided localizationof thelesion areafineneedlepuncture samplingthe Punctureneedleresidual fluid was applied to two slidesand respectivelytheothertwo clean slides were stacked,lightly pressed,and pulledapartat a uniform speed in the reverse direction to make four smears,which were quickly placed in 95%alcohol forfixation and thenremoved for drying.Dfferences between the two staining methods in lung occupying lesions were evaluated by fluorescent ROSEstaining and ROSE staining.Ninety-four patients were screened for definitive pathological diagnosis based on histopathologicalfindings,of which 66 were confirmed malignant tumors and 28 were non-neoplastic lesions.Patients withfungal and Mycobacterium antacidum-positive is non-neoplastic lesions.The sensitivity and specificity of the two methods for the cytological diagnosisof lung malignant tumors were analyzed using the pathohistological results as the gold standard,and the differences in the cyto-logical diagnostic value of the two methods for lung malignant tumors were evaluated.ResultsThe overall confirmed diagnosisrates of fluorescent ROSE and ROSE groups were 60.64%and 48.94%respectively(P<0.05);the sensitivity of diagnosinglung malignant tumors was 68.18%in both groups(P>0.05);and the specificity of the fluorescent ROSE and ROSE groupswere 42.86%and 3.57%(P<0.05),respectively.Conclusion Fluorescence ROSE combined with PTLBcan improve the confirmation rate of lung occupying lesions,especially the specificity of cytological diagnosis of lung malignant tumors,which hascertain clinical application value in the cytological diagnosis of lung occupying lesions.

关 键 词：荧光细胞学现场快速评估 恶性肿瘤:CT引导经皮肺活检 细胞学 

分 类 号：R734[医药卫生—肿瘤]