针吸细胞块技术在肺癌诊断及鉴别诊断中的意义

The significance of fine needle aspiration cytology in the diagnosis and differential diagnosis of lung cancer

目的探讨针吸细胞块技术,结合免疫组织化学检测在肺癌诊断中的意义。方法收集120例锁骨上及颈部肿块,经细针穿刺涂片见到肿瘤细胞的病例,行细针穿刺抽吸细胞制做细胞块,常规切片,HE染色,免疫组织化学检测。结果120例患者中转移性肺癌112例确诊率93.3%(112/120)。112例肺癌中腺癌(包括细支气管肺泡癌)62例,鳞癌38例,小细胞癌8例,大细胞癌4例。其余8例中转移性胃癌4例;转移性乳腺癌2例;结核2例。肺腺癌TTF-1阳性表达阳性率93.5%(58/62);肺鳞癌P63阳性表达阳性率92.1%(35/38)。结论应用针吸细胞块技术结合免疫组织化学检测,能确定肿瘤组织学类型,提高细胞学诊断的准确性,有助于肺癌的诊断及鉴别诊断。

Objective To investigate the the significance of fine needle aspiration cytology combined with immunohistochemistry in the diagnosis of lung cancer. Methods Fine needle aspiration cytology was made in cell blocks on 120 cases with cervical nubble, and the casescrvical nubbles were testified to be tumorous by fine needle aspiration cytology. The cell blocks were examined histopathologically and immunohistochemistry. Results Of the 120 cases, 112 （93.3%） were metastatic lung cancer; 4 were metastatic gastric cancer; 2 were metastatic breast cancer and 2 were tuberculosis. In the 112 metastatic lung cancer cases, 62 cases were pulmonary adenocarcinoma, 38 cases were squamous cell carcinoma, 8 cases were small cell carcinoma and 4 cases big cell carcinoma. Of the 6：2 pulmonary adenocarcinoma, 58 （93.5%） expressed TTF-1 and of the 38 squamous cell carcinoma, 35 （92. 1% ） expressed 1763. Conclusions The cell blocks technique combined with immunohistochemistry by fine needle aspiration cytology could determine the histology type of tumor and improve the accuracy of cytologic diagnosis, which is beneficial to the diagnosis and differential diagnosis of lung cancer.