液基细胞学检测在良恶性胸腹水鉴别诊断中的应用

Application of Liquid Based Cytology in Differential Diagnosis of Benign and Malignant Hydrothorax and Ascites

目的探讨液基细胞学检测在良恶性胸腹水鉴别诊断中的应用价值.方法收集胸腹水标本947例,包括胸水752例,腹水195例.常规进行传统细胞学和液基细胞学检查,比较二者在制片质量、满意度和检测结果的差异.结果 (1)传统涂片细胞学制片阳性细胞数量少而且分散,细胞分布厚薄不均,部分细胞有重叠、堆积现象,背景不清晰,有红细胞和炎性渗出物的干扰.而液基细胞学制片阳性细胞数量多而集中,细胞成单层分布、均匀、无重叠现象,背景清晰、干净.液基细胞学制片满意度(95.2%)明显高于传统细胞学制片满意度(86.5%),P<0.05;(2)在总共947例胸水和腹水标本中,传统细胞学检查阳性率为24.6%(可疑+确诊),液基细胞学检查阳性率为27.2%,略高于传统细胞学检查,但差异无统计学意义(P>0.05).结论液基细胞学在胸腹水标本的制片质量和制片满意度方面优于传统涂片细胞学,对恶性胸腹水的诊断阳性率略高于传统细胞学.

Objective To investigate the clinical application value of liquid based cytology（LBC） in differential diagnosis of benign and malignant hydrothorax and ascites.Me thods Nine hundreds and forty- seven cases of hydrothorax and ascites samples, including 752 cases of hydrothorax and 195 cases of ascites, were collected. Liquid based cytology（LBC） test and conventional cytology（CC） test were performed to differentially diagnose benign and malignant hydrothorax and ascites, and the difference in the quality and satisfaction of cell slide preparation and the diagnostic results were compared between the two cytology tests.Re s ults（1） Cell slide prepared with CC： the positive cells were few and scattered and had more overlap, the cell distribution was thick and uneven, the background was not clear and often interfered by red blood cells and inflammatory exudate. Cell slide prepared with LBC： the positive cells were more and concentrated and had no overlap, the cell distribution was uniform and in monolayer, the background was clean and clear. The satisfaction rate of slide preparation with CC and LBC was 86.5% and 95.2%, respectively（P〈0.05）.（2） In the total 947 cases of hydrothorax and ascites,the positive rate（27.2%） of LBC test was a little higher than CC test（27.2% vs. 24.6%）,but the difference had no statistical significance（P〉0.05）. Conclusion Liquid based cytology is better than conventional cytology in the quality and satisfaction of the cell slide preparation of hydrothorax and ascites samples, and has a little higher positive diagnostic rate of malignant hydrothorax and ascites.