细胞蜡块结合免疫组化在浆膜腔积液诊断中的应用  

Application of cell wax block combined with immunohistochemistry in the diagnosis of serous cavity effusion

作　　者：李君 胡金 LI Jun;HU Jin(Department of Pathology,Zhongxiang People’s Hospital,Hubei,Zhongxiang 431900,China)

机构地区：[1]湖北省钟祥市人民医院病理科,湖北钟祥431900

出　　处：《中国医药科学》2024年第15期143-146,共4页China Medicine And Pharmacy

摘　　要：目的探讨浆膜腔积液细胞蜡块结合免疫组化在病理诊断中的应用。方法回顾性分析钟祥市人民医院2022年6月至2023年6月接收的可疑恶性浆膜腔积液标本81例,所有样本均进行常规细胞学涂片及细胞蜡块结合免疫组化检查。以手术或活检病理诊断为金标准,对比分析两种检查方法的诊断结果及诊断效能。观察两种检查方法镜下细胞特征,结合免疫组化判断恶性浆膜腔积液的肿瘤来源。结果81例浆膜腔积液标本通过手术或活检病理诊断70例恶性。常规细胞学涂片诊断灵敏度为52.9%,特异度为54.5%,准确率51.9%;细胞蜡块结合免疫组化诊断灵敏度为95.7%,特异度为27.3%,准确率为92.6%。细胞蜡块结合免疫组化诊断灵敏度及准确率显著高于常规细胞学涂片,差异有统计学意义(P<0.05)。细胞蜡块结合免疫组化检出67例阳性,其中肺腺癌47例、乳腺癌4例、卵巢癌5例、消化道来源6例、甲状腺癌2例、肺小细胞癌1例、恶性间皮瘤2例。结论细胞蜡块结合免疫组化可提高浆膜腔积液细胞诊断准确率,通过免疫组化可明确判断肿瘤组织来源。Objective To investigate the application of cell wax block combined with immunohistochemistry in pathological diagnosis of serous cavity effusion.Methods A total of 81 cases of suspected malignant serous cavity effusion admitted to Zhongxiang People’s Hospital from June 2022 to June 2023 were analyzed retrospectively.All samples were examined by conventional cytology smear and cell wax block combined with immunohistochemistry.The pathological diagnosis of surgery or biopsy was the gold standard,and the diagnostic results and diagnostic efficiency of the two examination methods were compared and analyzed.The microscopic characteristics of the two examination methods were observed,and the tumor source of malignant serous cavity effusion was judged by combining with immunohistochemistry.Results Of the 81 cases of serous cavity effusion,70 cases were diagnosed as malignant by surgery or biopsy.The diagnostic sensitivity,specificity and accuracy of conventional cytology smear were 52.9%,54.5%and 51.9%,respectively.The diagnostic sensitivity,specificity and accuracy of cell wax block combined with immunohistochemistry were 95.7%,27.3%and 92.6%,respectively.The diagnostic sensitivity and accuracy of cell wax block combined with immunohistochemistry were obviously higher than those of conventional cytology smear,with statistically significant differences(P<0.05).A total of 67 positive cases were detected by cell wax block combined with immunohistochemistry,including 47 cases of lung adenocarcinoma,4 cases of breast cancer,5 cases of ovarian cancer,6 cases of digestive tract origin,2 cases of thyroid cancer,1 case of small cell lung cancer and 2 cases of malignant mesothelioma.Conclusion The combination of cell wax block and immunohistochemistry can improve the diagnostic accuracy of serous cavity effusion cells,and the source of tumor tissue can be clearly determined by immunohistochemistry.

关 键 词：浆膜腔积液 细胞蜡块 细胞涂片 免疫组化 

分 类 号：R730[医药卫生—肿瘤]