细胞蜡块联合免疫组化在诊断恶性浆膜腔积液中的临床意义

Clinical Significance of Cell Wax Block Combined with Immunohistochemistry in Diagnosis of Malignant Serosal Effusion

目的:探讨细胞蜡块联合免疫组化在诊断恶性浆膜腔积液中的临床意义,以期为临床早期制定治疗方案提供可参考数据。方法:选取2019年5月—2023年2月舞钢市人民医院收治的浆膜腔积液患者83例作为研究对象,均行细胞蜡块、免疫组化检查,以病理检查作为金标准,分析细胞蜡块联合免疫组化的诊断价值(敏感度、特异度、准确度、阳性预测值、阴性预测值)、类型检出率。结果:病理活检结果为恶性40例、良性43例;细胞蜡块+免疫组化诊断敏感度、准确度、阴性预测值均高于单一细胞蜡块、免疫组化,差异有统计学意义(χ^(2)=19.781、8.910、12.019,P<0.05);与细胞蜡块、免疫组化相对比,细胞蜡块+免疫组化类型检出率明显较高。经一致性分析,细胞蜡块+免疫组化的Kappa值为0.748(95%CI:0.697~0.802),明显高于单一细胞蜡块、免疫组化,差异有统计学意义(χ^(2)=13.903,P<0.05)。结论:细胞蜡块+免疫组化可有效鉴别浆膜腔积液性质以及类型,便于临床早期制定针对性治疗措施。

Objective:To explore the clinical significance of cell wax block combined with immunohistochemistry in the diagnosis of malignant serosal effusion,in order to provide reference data for early clinical treatment.Methods:A total of 83 patients with serosal effusion admitted to the hospital from May 2019 to February 2023 were selected as the study subjects.All of them were examined by cell wax block and immunohistochemistry.The diagnostic value(sensitivity,specificity,accuracy,positive predictive value and negative predictive value)and type detection rate of cell wax block combined with immunohistochemistry were analyzed with pathological examination as the gold standard.Results:The pathological biopsy results were 40 malignant cases and 43 benign cases.The diagnostic sensitivity,accuracy and negative predictive value of cell wax block+immunohistochemistry were higher than those of single cell wax block and immunohistochemistry(χ^(2)=19.781,8.910,12.019;P<0.05).Compared with cell wax block and immunohistochemistry,the detection rate of cell wax block+immunohistochemistry type was significantly higher.Through consistency analysis,the Kappa value of cell wax block+immunohistochemistry was 0.748(95%CI:0.697~0.802),which was significantly higher than that of single cell wax block and immunohistochemistry(χ^(2)=13.903,P<0.05).Conclusion:The cell wax block and immunohistochemistry can effectively distinguish the nature and type of serous cavity effusion,which is convenient to formulate targeted treatment measures in early clinical stage.