超声引导下细针穿刺细胞学检查联合细胞块免疫组织化学在老年人浅表淋巴结病变诊断中的应用

Application of ultrasound-guided fine-needle aspiration cytopathology combined with cell block immunohistochemistry in the diagnosis of lymph node lesions in elderly patients

目的 探讨超声引导下细针穿刺细胞学检查联合细胞块免疫组织化学对于老年患者浅表淋巴结疾病诊断的临床应用价值. 方法 2014年1月至2015年2月我院收治的老年浅表淋巴结病变患者55例,采用超声引导下细针穿刺抽吸,所获得标本送细胞学检查和细胞块免疫组织化学检测.对单纯细胞学检查及细胞学检查与细胞块免疫组织化学联合应用的诊断结论并结合随访结果进行回顾性分析及对比. 结果 本组病例穿刺取材成功率为96.4％（53/55）.53例患者中,43例细胞学检查结果与随访结果相符,临床诊断符合率为81.1％（43/53）.50例细胞学检查与细胞块免疫组织化学联合诊断结果与随访结果相符,临床诊断符合率为94.3％（50/53）.两种不同方法检测结果比较,细胞学检查联合细胞块免疫组织化学临床诊断符合率优于单纯细胞学检查（P＜0.05）.结论 超声引导细针抽吸细胞学检查联合细胞块免疫组织化学诊断淋巴结病变简便实用、安全可靠,可提高临床诊断符合率,对于高龄体弱患者具有较高的临床应用价值和推广前景.

Objective To explore the clinical value of ultrasound guided fine-needle aspiration （FNA） cytopathology combined with FNA cell block immunohistochemistry in diagnosing lymph node diseases for elderly patients.Methods A total of 55 elderly patients with lymph node lesions who were admitted to our hospital from January 2014 to February 2015 were treated by ultrasound-guided fine-needle aspiration.The obtained samples were sent for cytopathology,and FNA cell block was detected by immunohistochemistry.The diagnostic conclusions and the follow-up results were retrospectively analyzed and compared.Results The success rate of FNA cytology of this group was 96.4% （53/55）.Among 53 patients,the results of cytological examination in 43 cases were consistent with the follow up results.The coincidence rate of clinical diagnosis was 81.1% （43/53）.The results of the cytology combined with cell block immunohistochemistry in 50 cases were consistent with the follow up results.The coincidence rate of clinical diagnosis was 94.3 % （50/53）.The clinical diagnostic accordance rate of cytology combined with cell block immunohistochemistry was better than that of cytology alone （P 〈 0.05）.Conclusions Ultrasound-guided fine-needle aspiration cytopathology combined with FNA cell block immunohistochemistry in diagnosis of lymph node lesions is simple,practical,safe and reliable,which can significantly improve the diagnosis rate.It has a higher clinical application value and promotion prospects,especially for frail elderly patients.