细胞块石蜡切片检查对恶性浆膜腔积液的诊断价值

Effectiveness of Cellblock Paraffin-Imbedded Sections in Diagnosis of Malignant Serous Cavity Effusion

目的探讨细胞块石蜡切片检查对恶性浆膜腔积液的诊断价值。方法对560例于2009年5月-2013年5月在本院就诊的胸腔、腹腔和心包积液患者的穿刺抽取液分别采用细胞块石蜡切片法与常规离心涂片法进行细胞学检查,统计并分析两种方法和两种方法联用对恶性浆膜腔积液的诊断符合率。结果 560例浆膜腔积液患者中,经手术病理、纤维支气管镜、胸腹腔镜、影像引导下穿刺活检、诊断性治疗等确诊为恶性肿瘤并发积液的有210例。常规离心涂片法对恶性浆膜腔积液的敏感度为57.6%,特异度为98.8%;细胞块石蜡切片法对恶性浆膜腔积液的敏感度为69.5%,特异度为99.4%,两种方法敏感度比较差异具有统计学意义（P〈0.05）;两种方法联用对恶性浆膜腔积液的敏感度为72.3%,特异度为100%。结论在对浆膜腔的穿刺抽取液进行细胞学检查时,细胞块石蜡切片法要优于常规离心涂片法,两种方法联用可进一步提高对恶性浆膜腔积液的诊断符合率。

Objective To discuss the effectiveness of cellblock paraffin-imbedded sections in diagnosis of malignant serous cavity effusion.Methods A total of 560 patients were selected among all the patients with pleural,ascites and pericardial effusion who had been treated in the hospital from May 2009 to May 2013.The cellblock paraffin-imbedded sections and the cell centrifugation smear had been performed to make cytological examinations of pleural,ascites and pericardial effusion for these patients.The accuracy rates of two methods and combined use of two methods in diagnosis of malignant serous cavity effusion were analyzed respectively.Results Among 560 cases,210 were identified with malignant serous cavity effusion through the surgical pathology,fiberoptic bronchoscopy,laparoscope,imagingguided needle biopsy and diagnostic treatment.The sensibility and specificity of the cell centrifugation smear were 57.6% and 98.8% in comparison with the cellblock paraffin-imbedded sections＇ 69.5% and 99.4% respectively.There were statistically significant differences（P〈0.05） between two methods.The sensibility and specificity of the combined use of the two methods were 72.3% and 100%.Conclusion Cellblock paraffin-imbedded sections demonstrated its superiority over the cell centrifugation smear in cytological examinations of serous cavity effusion.Combined use of two methods can further improve the accuracy rate in diagnosis of serous cavity effusion.