细胞块石蜡包埋切片和细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果比较

Comparison of Paraffin-embedded Cell Block and Smear in the Differential Diagnosis of Benign and Malignant Pleural Effusion

目的对比细胞块石蜡包埋切片和细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果.方法随机选取安康市中医医院2012年5月至2015年5月收治的胸腹腔积液患者80例,每1例送检标本分为2份,1份应用细胞块石蜡包埋切片法检测,另1份应用细胞涂片法检测.结果细胞块石蜡包埋切片的细胞学诊断阳性率28.8%(23/80)显著高于细胞涂片22.5%(18/80),P<0.05,细胞病理学诊断的腺癌检出率32.5%(26/80)显著高于细胞涂片20.0%(16/80),P<0.05;80例标本中,31例为血性胸腹腔积液,其中13例为恶性,阳性率为41.9%;49例为非血性胸腹腔积液,其中11例为恶性,阳性率为22.5%.血性胸腹腔积液细胞病理学诊断的阳性率显著高于非血性胸腹腔积液(P<0.05).结论细胞块石蜡包埋切片比细胞涂片鉴别诊断良、恶性胸腹腔积液的临床效果好.

Objective To compare the clinical effects of paraffin-embedded cell block and smear in the differential diagnosis of benign and malignant pleural effusion. Methods 80 cases of patients with pleural effusion from May 2012 to May 2015 were randomly selected, each pleural effusion sample was divided into 2 parts, 1 part paraffin-embedded sections were detected by cell block method, and 1 part by cell smear.Results The positive rate of cytology cell block paraffin-embedded sections 28.8%（23/80） was significantly higher than smear 22.5%（18/80）,P〈 0.05, the detection rate of cytopathology diagnosis of cancer 32.5%（26/80） was significantly higher than smear 20.0%（16/80）,P〈 0.05;Among the 80 cases of specimens,31 cases were bloody ascites and pleural effusion,of which 13 cases were malignant,the positive rate was 41.9%;56 cases were non-bloody chest ascites,of which 11 cases were malignant, the positive rate was 19.6%. The positive rate of fluid cytopathology diagnosis of bloody abdominal cavity was significantly higher than non-bloody ascites and pleural effusion, P 〈0.05.Conclusion The clinical effect of paraffin-embedded cell block in the differential diagnosis of benign and malignant pleural effusion is better than smear.