TCT检测技术在肺癌诊断中的应用价值

Value of ThinPrep Cytology Test Technique in Diagnosis of Lung Cancer

[目的]探讨膜式超薄液基细胞学检测技术(ThinPrep cytology test,TCT)在肺癌诊断中的应用价值。[方法]对591例(肺癌323例,非肺癌268例)支气管肺泡灌洗液(bronchoalveo-lar lavage fluid,BALF)或纤维支气管镜刷片标本同时进行TCT和直接涂片法检测,比较两种方法的敏感度、特异性、阳性预测值和准确率。[结果]TCT检测的敏感度为36.5%,特异性为99.6%,阳性预测值为99.2%,准确率为65.1%。直接涂片法检测敏感度为13.6%,特异性为100%,阳性预测值为100.0%,准确率为52.8%。TCT检测的敏感度、准确率均高于直接涂片法(χ2=72.014,P=0.000;χ2=4.817,P=0.028)。无论纤支镜下可见肿瘤征象或未见肿瘤征象,BALF的TCT检测敏感度与纤维支气管镜刷片的TCT检测敏感度比较,差异均无统计学意义(χ2=3.548,P=0.06;χ2=0.031,P=0.859)。[结论]TCT检测可提高肺癌诊断率,BALF的TCT检测可推广应用于临床。

[Purpose] To investigate the application value of ThinPrep cytology test （TCT） in diagno- sis for lung cancer. [Methods]Five hundred and ninety-one cases （323 cases with lung cancer and 268 cases with benign lung disease） of bronchoalveolar lavage fluid （BALF） or bronchial brushing cytology were detected by both TCT and direct smear method. The sensitivity, specificity, positive predictive value and accuracy of two methods were compared. [Results] The sensitivity, specificity, positive predictive value and accuracy of TCT were 36.5%, 99.6%, 99.2% and 65.1%, respectively. And those of direct smear method were 13.6%, 100%, 100%, 52.8%, respectively. The sensitivity and accuracy of TCT was significantly higher than those of direct smear method in diagnosis for lung cancer （χ^2=72.014,P=0.000;χ^2=4.817,P=0.028）. No matter there were signs of tumor under branchofiberoscopy or not, there was no significant difference of the sensitivity between TCT of BALF and bronchial brushing cytology（χ^2=3.548,P=0.06; χ^2=0.031,P=0.859）. [Conclusion] TCT can improve the diagnosis ability of lung cancer and BALF by TCT can be applied widely to clinical.