一种新型细胞蜡块立埋技术在浆膜腔积液病理诊断中的应用  

Application of a new type of cell wax block vertical embedding technique in the pathological diagnosis of serous cavity effusion

作　　者：张兰兰 杨莉 郭英 杨巧 陈佳 张义磊 ZHANG Lanlan;YANG Li;GUO Ying;YANG Qiao;CHEN Jia;ZHANG Yilei(School of Basic Medicine,Xi’an Jiaotong University,Xi’an 710065,China;Xi’an Daxing Hospital,Xi’an 710016,China;Department of Pathology,Xijing Hospital,the Air Force Medical University,Xi’an 710032,China;Northwestern University School of Medicine,Xi’an 710069,China)

机构地区：[1]西安交通大学基础医学院,西安710065 [2]西安大兴医院病理科,西安710016 [3]空军军医大学第一附属医院[西京医院]病理科,西安710032 [4]西北大学医学院,西安710069

出　　处：《广西医科大学学报》2024年第12期1664-1670,共7页Journal of Guangxi Medical University

基　　金：国家自然科学基金资助项目(No.82260319)。

摘　　要：目的:介绍一种新型细胞蜡块立埋技术在浆膜腔积液病理诊断中的应用。方法:对西安大兴医院近9年4437例浆膜腔积液细胞蜡块标本进行分组实验,比较1472例传统细胞蜡块包埋和2965例改良后立埋方法对细胞病理精准诊断的影响。结果:改良前细胞蜡块免疫细胞化学染色(ICC)精确诊断恶性肿瘤类型及来源为67.8%(206/304),用立埋改良后经ICC诊断明确类型及来源者为97.1%(469/483),差异有统计学意义(P<0.05)。立埋后的细胞蜡块具有与组织学类似的形态学表现,改良后细胞蜡块结合ICC恶性肿瘤诊断精确率上升,已通过ICC明确诊断腺癌、鳞状细胞癌、小细胞癌、间皮瘤、乳腺癌、恶性黑色素瘤、软组织肉瘤等多种肿瘤类型,腺癌最多见,其中呼吸系统来源最多,消化系统次之,阳性率在12.8%~21.0%。结论:对细胞蜡块包埋方法进行立埋改良,便于免疫细胞化学多项抗体标记时的比较分析,有效地协助细胞病理医生判断恶性肿瘤的来源及类型,提高细胞病理诊断的准确率,经临床实践效果好,应用价值高,值得推广。Objective:To introduce the application of a new type of cell wax block vertical embedding technique in the pathological diagnosis of serous cavity effusion.Methods:Group experiments were carried out on 4,437 cell wax block specimens of serous cavity effusion in Xi’an Daxing Hospital in the past nine years.The impacts of the traditional cell wax block embedding method in 1,472 cases and the modified vertical embedding method in 2,965 cases on the accuracy of cytopathological diagnosis were compared.Results:The accurate diagnosis of the type and origin of malignant tumors was 67.8%(206/304)by immunocytochemical staining(ICC)before the improvement,and 97.1%(469/483)by immunocytochemical staining after the improvement of embedding.The difference was statistically significant(P<0.05).The cellular morphology of the embedded cell block closely re‐sembled that observed in histology.Following the implementation of improved cell block techniques combined with immunocytochemical staining,there was a notable enhancement in the accuracy of diagnosing malignant tu‐mors.ICC clearly identified adenocarcinoma,squamous cell carcinoma,small cell carcinoma,mesothelioma,breast cancer,malignant melanoma,soft tissue sarcoma,and other tumor types,with adenocarcinoma being the most frequently encountered subtype.Among these cases,respiratory system malignancies were found to be the most prevalent followed by those originating from the digestive system.The positive detection rates ranged be‐tween 12.8%and 21.0%.Conclusion:The improved embedding method of cell wax block is convenient for com‐parison and analysis of immunocytochemical multiple antibody labeling,effectively assisting cytopathologists to judge the source and type of malignant tumors,and improving the accuracy of cytopathological diagnosis.It has good effect in clinical practice and high application value,and thus is worthy of recommendation.

关 键 词：细胞蜡块 立埋 浆膜腔积液 细胞病理诊断 

分 类 号：R361.2[医药卫生—病理学]