卵巢交界性囊腺瘤术中腹水或冲洗液细胞学检查的诊断价值

Cytological diagnosis of intraoperative ascites or lavage fluid in low malignant potential borderline cystadenoma of ovary

目的探讨卵巢交界性囊腺瘤术中腹水或冲洗液细胞学检出率与细胞学涂片的形态学特征。方法收集521例术中积液或冲洗液细胞学涂片,回顾性分析了30例卵巢交界性囊腺瘤细胞学涂片,探讨其细胞形态特征及诊断价值。结果 521例积液或冲洗液中,30例为卵巢交界性囊腺瘤,细胞学检出16例(53.3%)。30例中18例为浆液性,10例为黏液性,2例为混合性。卵巢交界性囊腺瘤细胞学涂片显示,细胞异型性不明显,有明显上皮结构可提示为肿瘤而非间皮细胞。增生间皮细胞偶可呈乳头结构,但乳头较平铺,无三维立体感。结论卵巢浆液性交界性囊腺瘤的细胞学检出率相对较高。术中腹水或冲洗液细胞学涂片中,卵巢交界性囊腺瘤细胞/卵巢腺癌细胞与增生活跃的间皮细胞容易鉴别,而交界性囊腺瘤细胞与腺癌细胞较难鉴别。染色质明显增粗和核形不规则是鉴别两者最有意义的形态学特征。

Objective To explore the influencing factor of cytological detection rate of intraoperative ascites or lavage fluid in low malignant potential borderline cystadenoma of ovary and its ＇ cells ＇ morphological characteristics in the cytological slides. Methods 521 patients in this hospital were enrolled in this study. The cytological slides of 30 low malignant potential borderline cystadenomas of ovary and their characteristics were retrospectively analyzed to explore the morphological features and the value of diagnosis. Results 30 low malignant potential borderline cystadenomas of ovary were found in the 521 intraoperatively obtained samples. 16 of them were detected by cytology, accounting for 53.3%. There were 18 serous, 10 mucous and 2 mixed. Cell atypia of low malignant potential borderline cystadenoma of ovary was unconspicuous, but the epithelial structure could point out tumors other than mesothelial cells. Hyperplastic mesothelial cells could have papillary fragment, but the papillary fragment was comparatively flied and did not have third dimension. Conclusion The cytological detection rate of the serous low malignant potential borderline cystadenoma of ovary is comparatively higher. In the cytological slides of intraoperative ascites or lavage fluid, cells of the low malignant potential borderline cystadenoma or the adenoearcinoma of ovary are easy to be distinguished from hyperplastic mesothelial cells, while cells of low malignant potential borderline cystadenoma are more difficult to be distinguished from the adenocarcinoma cells and the most significances in differential diagnosis are the coarse chromatin and the irregularity of nuclear morDholoay.