液基细胞学和传统涂片法在痰液标本诊断肺癌中的价值比较

Comparative analysis of conventional smear and liquid-based cytology method to diagnose lung cancer in sputum samples

目的评价液基细胞学在痰液标本中的应用价值。方法对临床送检的287例痰液标本行液基细胞学方法处理,并与传统涂片方法进行比较分析。结果液基细胞学和传统涂片法检出肺癌的灵敏度分别为21.6%(62/287)和17.1%(49/287),两者相比差异无统计学意义;但两种方法联用灵敏度可达24.0%,与传统涂片法相比差异有统计学意义(P<0.05),而与液基细胞学方法比较差异不显著。液基细胞学和传统涂片法诊断肺癌的假阴性率分别为38.6%和48.5%,两者相比差异无统计学意义;但两种方法联用假阴性率为31.7%,与传统涂片法相比差异有统计学意义(P<0.05),而与液基细胞学方法比较差异不显著。结论通过痰液标本检测肺癌细胞,液基细胞学要好于传统涂片法,具有明显的优越性;两者联用可提高肺癌的检出率,值得临床大力推广。

Objective To make a comparative analysis of conventional smear and liquid-based cytology method to diagnose lung Cancer in sensitivity and false-negative, and evaluate the application value of liquid-based cytology in sputum samples. Methods We collected 287 sputum samples through clinical contrast conventional smear with liquid-based cytology method. The diagnosis was made by the same pathology panel in double blind way. We compared the two methods to diagnose lung cancer in sensitivity and false-negative. Results Liquid-based cytology method detected 62 cases of lung cancer, and conventional smear detected 49 cases of lung cancer, with the sensitivity rate being 21.6% and 17.1%, respectively. Combination of the two methods made the sensitivity rate 24.0%. The false-negative rate was 38.6% for liquid-based cytology method and 48.5% for conventional smear which did not differ significantly. By combining the two methods, the false-negative rate was 24.0%. There was no significant difference between liquid-based cytology method and conventional smear, and between liquid-based cytology method and the two-method combination in sensitivity and false-negative. But there was a significant difference between the two-method combination and conventional smear. Oonclusion Through sputum sample detection of lung cancer cell, liquid-based cytology method is better than conventional smear, the former having obvious superiority; combining the two methods can detect more lung cancers. Therefore, it is a superior screening test in detecting lung cancer and worthy of clinical popularization.