液基细胞学检测技术和传统细胞学涂片对肺癌的诊断价值比较

Comparison between Values of Liquid-based Cytology Test and Conventional Smear in Diagnosis of Lung Cancer

目的比较液基细胞学检测(liquid-based cytology test,LCT)技术和传统细胞学涂片(coventional smear,CS)检测不同标本对肺癌的诊断价值。方法研究标本包括痰液、胸腔积液、支气管黏膜刷检物、肺泡灌洗液和肺细针吸活检标本。对比上述两种方法诊断肺癌的敏感度、特异度、准确度、阳性预测值、阴性预测值;并分析两种方法的涂片质量和检出的癌细胞的形态结构。结果LCT法检测痰液、胸腔积液、支气管黏膜刷检物、支气管肺泡灌洗液、细针吸活检标本对诊断肺癌的敏感度分别为28.6%、37.5%、37.5%、30.0%、87.5%;准确度分别为65.2%、75.0%、62.1%、57.6%、91.5%;阴性预测值分别为59.6%、70.6%、51.0%、48.1%、78.9%;CS法检测痰液、胸腔积液、支气管黏膜刷检物、支气管肺泡灌洗液、细针吸活检标本诊断肺癌的敏感度分别为14.3%、12.5%、22.5%、15.0%、75.0%;准确度分别为58.3%、65.0%、53.0%、48.5%、83.0%;阴性预测值分别为55.1%、63.2%、45.6%、43.3%、65.2%。LCT法在涂片质量、癌细胞形态学判断方面较CS法好。结论LCT法检测痰液、胸腔积液、支气管黏膜刷检物、支气管肺泡灌洗液及肺细针吸活检物诊断肺癌的敏感度、准确度、阴性预测值均较CS法高,故LCT法对肺癌的诊断价值高于CS法,涂片质量也明显优于CS法。

Objective To compare the values of liquid-based cytology test（LCT） and conventional smear（CS） in diagnosis of lung cancer.Methods The researched specimens included sputum,pleural effusion,bronchial mucosa brush biopsy,alveolar lavage fluid and lung fine-needle aspiration biopsy specimens.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value were compared between 2 methods in diagnosis of lung cancer,and the quality of smear and the detected cancer cell morphology were analyzed.Results The sensitivities of LCT in detecting sputum,pleural effusion,bronchoscopy mucosa brush biopsy,bronchoalveolar lavage fluid,fine-needle aspiration biopsy specimens were 28.6%,37.5%,37.5%,30.0%,87.5%,respectively;the accuracy 65.2%,75.0%,62.1%,57.6%,91.5%,respectively;negative predictive value 59.6%,70.6%,51.0%,48.1%,78.9%,respectively;the sensitivities of CS method were 14.3%,12.5%,22.5%,15.0%,75.0%,respectively;the accuracy 58.3%,65.0%,53.0%,48.5%,83.0%,respectively,negative predictive value 55.1%,63.2%,45.6%,43.3%,65.2%,respectively.Conclusion The sensitivity,accuracy and negative predictive value of LCT method are higher than those of CS in detecting sputum,pleural effusion bronchial mucosa brush biopsy,bronchoalveolar lavage specimens and lung fine-needle aspiration biopsy.So LCT method is superior to CS in smear quality and judgment of cancer cell morphology.