透射电镜在胸膜恶性肿瘤诊断中的作用

Role of transmission electron microscopy in the diagnosis of malignant pleural tumors

目的探讨透射电镜在胸膜恶性肿瘤病理诊断中的作用。方法对49例同时送检光镜和电镜检查、并经二者或其中之一确诊为恶性肿瘤的胸膜活检标本进行对比分析,比较两者的诊断符合情况并分析不相符的原因。结果透射电镜与光镜诊断结果的完全符合率、基本符合率、不符合率分别为33/49例(67.3%)、7/49例(14.3%)和9/49例(18.4%)。诊断基本相符的7例病例,6例经超微病理观察进一步完善或明确了光镜诊断;诊断不相符的9例均经一种方法诊断为腺癌而另一种方法仅观察到炎症或坏死。结论联合应用光镜和透射电镜可提高胸膜活检标本病理诊断的阳性率和准确率。

Objective To evaluate the clinical significance of transmission electron microscopy （TEM） in pathological diagnosis of malignant pleural tumors. Methods A total of 49 cases of pleural biopsy speci- mens were selected for TEM examination. The diagnoses of TEM and light microscopy were compared to analyze the coincidence rate. Results Among the 49 patients, TEM results of 33 cases （67.3%） were fully consistent with the light microscopic diagnosis. Of the 7 （14.3%） basically consistent cases, 6 were further improved or confirmed by TEM. All of the 9 inconsistent cases were diagnosed as adenocarcinomaby one of the two methods, light microscopy er. Conclusions Combined application of light or TEM, but only inflammation or necrosis by the oth- microscopy and TEM can improve the positive rate and di- agnostic accuracy of malignant pleural tumors.