肺癌患者胸水中腺癌细胞的超微病理诊断

Ultrastructural diagnosis of adenocarcinoma cells in pleural fluid of patients with lung cancer

探讨肺癌患者胸水中腺癌细胞的超微结构特点及与反应性间皮细胞的鉴别,分别对41例肺腺癌患者胸水中的癌细胞和对照组10例胸水中反应性间皮细胞进行超微结构对比观察。肺腺癌细胞表面的微绒毛、核凹陷和胞浆内的分泌颗粒、连接复合体及板层小体等超微结构均有助于与反应性间皮细胞的鉴别,其中短棒状微绒毛作为腺癌细胞形态特征标志,检出率为92.7%,如果再结合观察细胞间的连接复合体,其检出率高达95.1%。在常规细胞病理学诊断的基础上,再进行电镜观察,对肺癌患者胸水中腺癌细胞的诊断及鉴别诊断具有重要的临床应用价值。

To study the ultrastructural characteristics of adenocarcinoma cells in pleural fluid of patients with lung cancer and differential diagnosis between these cells and reactive mesothelial cells. The ultrastructures of adenocarcinoma cells in pleural fluid of 41 patients with lung cancer and reactive mesothelial cells in pleural fluid of 10 patients were observed by transmission electron microscopy （TEM）. It is helpful in distinguishing adenocarcinoma cells from reactive mesothelial cells by observing microvilli on the surface of the adenocarcinoma cells, nucleus hollow and secreting granules in the cytoplasm, junctional complex, and osmiophilic lamellar bodies and so on, in particular microvilli, for the feature of the adenocarcinoma cells, detectable rate was 92.7% . If it combine with junctional complex, detectable rate was 95.1%. It is appeared to be important clinical value for diagnosing and differential diagnosis of carcinoma cells in pleural fluid of patients with lung cancer by TEM on the basis of routine cytopathology.