细胞块辅助支气管刷检液基细胞学在肺癌分型诊断的应用

Application of cell block assisting bronchial brushing liquid-based cytology in classification of lung cancer subtypes

目的探讨细胞块辅助支气管刷检液基细胞学在肺癌分型诊断中的应用。方法收集支气管刷检液基细胞学制片后剩余标本制备细胞块,应用免疫细胞化学检测Napsin A、TTF-1、p40、CD56在肺癌中的表达。结果43例肺癌中腺癌22例,鳞状细胞癌15例,小细胞癌6例。Napsin A诊断腺癌的敏感性和特异性分别为77.3%和100%;TTF-1诊断腺癌的敏感性和特异性分别为86.4%和75.0%;p40诊断鳞状细胞癌的敏感性和特异性分别为93.3%和100%;TTF-1诊断小细胞癌的敏感性和特异性分别为100%和48.6%;CD56诊断小细胞癌的敏感性和特异性分别为100%和91.9%。结论利用支气管刷检液基细胞学剩余标本制备细胞块,选择敏感性及特异性高的抗体进行标记,可提高细胞学在肺癌分型诊断的准确性。

Objective To study the value of cell block assisting bronchial brushing liquid-based cytology in classification of lung cancer. Methods The cell block was prepared using the specimen after liquid-based cytology.The expression of Napsin A,TTF-1,p40 and CD56 in those lung cancers were detected by immunocytochemistry.Results There were 43 cases of lung cancers in cytology,including 22 cases of adenocarcinoma,15 cases of squamous cell carcinoma and 6 cases of small cell lung carcinoma. The sensitivity and specificity of Napsin A were 77. 3% and1000%,and those of TTF-1 were 86. 4% and 75. 0%,respectively,in diagnosis of adenocarcinoma; those of p40 were93. 3% and 100. 0%,respectively,in diagnosis of squamous cell carcinoma; those of TTF-1 were 100. 0% and48. 6%,and those of CD56 were 100. 0% and 91. 9%,respectively,in diagnosis of small cell lung carcinoma.Conclusions The cell block,combined with a panel of antibodies with high sensitivity and specificity,is helpful to improve the differential diagnosis of lung cancer subtypes.