B超引导细针穿刺细胞块对肝癌的诊断价值

Diagnositic value of cell block of liver carcinoma by fine needle aspiation under ultrasonic guidance

目的:探讨经皮细针穿刺(fine needle aspiration,FNA)细胞块与涂片细胞学检查对肝细胞癌的诊断价值。方法:在B超引导下进行定位穿刺,应用细胞块切片检查和涂片细胞学检查方法观察168例临床疑为肝占位性病变的细针穿刺标本,其中肝恶性肿瘤101例。结果: FNA细胞块切片诊断正确率98．0％(99／101), FNA细胞学定性诊断率为90．1％(91／101)而分型诊断正确率仅为75．2％(76／101);两者之间差异有统计学意义,x2=20．09,P<0．01。结论:经B超引导下FNA细胞块切片检查,能够清晰显示细胞排列及组织结构,并且可多张切片做特殊染色及免疫组化染色,对组织定性和分型诊断接近术后病理诊断,与涂片细胞学结合诊断可优势互补,有很高应用价值。

OBJECTIVE：To explor the value of cell block and smear to liver cancer by fine needle aspiration（FNA）. METHODS： Total 168 cases of B-ultrasound guided fine needle aspiration were investigated and all the clinically suspected as liver tumors were studied by cell smear and cell block examination. One handred and one cases were diagnosed as malignant tumors. RESULTS： The diagnostic correct rate by cell block histology was 98.0% （99/101）, the positive rate by FNA was 90. 1 % （91/101）and the differentiate rate was 75.2% （76/101）. There was a significant difference,x^2 = 20. 69 ,P〈0. 01. CONCLUSIONS： The cell block examination by B-ultrasound guided fine needle aspiration could clearly show cytologic arrange and histology structure, and the special stain and immuni-histochemistry could be also used. The positive diagnosis apporoaches to the post-operative pathology. It is helpful to diagnose hepatic carcinoma if combining FNA.