细针穿刺结合免疫组织化学检测在颈部淋巴结恶性肿瘤鉴别诊断中的作用

Differential diagnosis of malignant tumor of cervical lymph nodes by immunohistochemistry and fine-needle aspiration cytology

目的:探讨细针穿刺(FNAC)结合免疫组织化学(IHC)在鉴别诊断颈部淋巴结恶性肿瘤中的作用与意义。方法:采用细针穿刺获得50例颈部肿大淋巴结组织,涂片进行HE染色,观察细胞形态,可疑的恶性肿瘤病变进行免疫组织化学检测。结果:单独FNAC分型确诊病例为35.7%,FNACIHC分型确诊病例为90.5%。FNAC-IHC对淋巴结肿瘤性病变的类型确诊率显著高于单独FNAC的确诊率。FNAC-IHC在颈部肿瘤性病变分型鉴别诊断的敏感度显著高于单独FNAC,而二者的特异性没有差别。结论:FNAC-IHC在颈部淋巴结恶性肿瘤的鉴别诊断价值优于FNAC。

Objective： To investigate the significance of using the fine needle aspiration cytology and immunohistochemistry assay to do differential diagnosis of malignant lesions of cervical lymph node. Methods： The cervical lymph nodes underwent fine needle aspiration and smeared, cell mor phology was observed by HE staining at first. Cases suspected for malignancy were further detected by immunohistochemistry for differential diagnosis. Results： Compared with final diagnosis in par affin section, diagnostic accuracy of FNAC was 35. 7%, diagnostic accuracy of FNAC-IHC was 90.5%. Diagnosis accurate rate of FNAC-IHC in the lymph node lesions was significantly higher than that of FNAC. Diagnosis sensitivity of FNAC-IHC was also significantly higher than that of separate FNAC, but there was no difference in specificity. Conclusion： Differential diagnosis of ma lignant tumor in the cervical lymph nodes by FNAC-IHC was superior to FNAC .