针吸细胞学检查在深部肿瘤切除术快速诊断中的应用研究

RAPID DIAGNOSIS OF DEEP-SEATED TUMORS WITH ACUPUNCTURE CYTOLOGICAL EXAMINATION

目的 探讨细针抽吸细胞学检查在深部肿瘤术中快速诊断中的价值。方法 对临床上手术探查或手术治疗的 116例深部肿瘤患者采用 2 0～ 30ml空针 ,9号注射针头 ,对手术中暴露的肿瘤组织进行直视下抽吸 ,抽吸物涂片自然干燥后 ,进行瑞 -姬氏和AgNOR染色 ,油镜下进行细胞学综合诊断。结果 116例肿瘤患者经术中单纯细胞学形态学诊断为恶性肿瘤 6 5例 (5 6 .0 % ) ,良性肿瘤 5 1例 (44.0 % )。与AgNOR染色结果结合后 ,其术中细胞学诊断为恶性肿瘤 78例(6 7.2 % ) ,良性肿瘤 38例 (32 .8% )。细胞学诊断良恶性肿瘤的准确性显著高于术中组织学快速诊断结果 ,与术后病理组织学诊断结果完全相符 5 6例 (48.3% ) ,基本相符 6 0例 (5 1.7% ) ,未出现假阳性和假阴性诊断结果 ,总阳性符合率为 10 0 %。结论 术中针吸细胞学诊断结果准确率高 (达10 0 % ) ,诊断时间短 (0 .5h左右 ) ,并且针吸创伤小 ,其并发症和假阴性均低于活检。针吸细胞学检查是用于深部器官、组织肿瘤诊断和鉴别诊断的重要手段 ,可为临床及时对深部器官、组织肿瘤的正确治疗提供重要依据。

Objective To explore the rapid diagnosis of deep-seated tumors with acupuncture cytological examination.Metods The aspirations of tumor tissues in 116 cases of deep-seated tumors were made with 20ml-30ml hollow needle and syringe needle No.9.The aspirate smears were stained with AgNOR method after natural drying and then general cytological diagnosis under oil immersion lens were made .Results The simple morphological diagnosis showed that 65 cases(56%)suffered from malignant tumors and 51(44%)benigh tumors, while the combination of AgNOR staining with intraoperative cytological diagnosis showed that 78cases(67.2%) suffered from malignant tumors and 38 cases (32.8%)benigh tumors.The accuracy of cytological examination was higher than that of intraoperative histological diagnosis of tumors.The cytological diagnostic results of 56 cases(48.3%)were completely consistant with the postoperative histopathological diagnostic results and other 60 cases(51.7%) got approximate coincidence.The total positive coincidence was 100% without any false positive or negative diagnostic results.Conclusion Intraoperative acupuncture cytological diagnosis has high accuracy(100%),takes up short time (0.5 hour), results in few tramata and shows less complications and less false negative diagnoses than biopsy. Acupuncture cytological examination can act as an important means to diagnose deep-seated tissue tumors and other lesions and can provide bases for clinical treatment.