摘要
目的探讨液基细胞学在超声支气管镜引导下经支气管纵隔淋巴结针吸活检术(EBUS-TBNA)中的诊断价值。方法前瞻性分析2012年6月至2013年9月四川大学华西医院呼吸与危重症医学科行EBUS-TBNA检查的600例患者。患者在局部麻醉和中度镇静的情况下,行EBUS-TBNA获取病理组织以及细胞学标本。对每例患者的抽吸活检组织均进行薄层液基细胞学检查及传统细胞学涂片。必要时,组织细胞采用免疫组化方法进行分析诊断并与组织学诊断进行比较。结果组织学检查确诊480例恶性肿瘤以及120例良性病变。Sure Path液基细胞学检查术与传统巴氏涂片法敏感性分别为82.1%和56.0%,特异性分别为87.5%和82.5%,阳性预测值分别为96.3%和92.8%,阴性预测值分别为54.9%和31.9%,差异有统计学意义(P<0.05)。两者联合特异性为100.0%。结论液基细胞学检测能提升EBUS-TBNA的细胞学检测的诊断价值。细胞学检测结果难以确诊时,需进行组织学检测。
Objective To investigate whether liquid-based cytology（ LBC） can improve diagnostic value of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration（ EBUS-TBNA）. Methods A cohort of 600 cases who underwent EBUS-TBNA from June 2012 to September 2013 was enrolled in this prospective study in West China Hospital. EBUS-TBNA was carried out under local anesthesia and moderate sedation. The procedure was performed with echobronchoscopes.Histological tissues were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis as necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer Sure Path method. Results In total,480 cases of malignant tumors and 120 cases of benign lesions were confirmed by histological examination. The sensitivity of Sure Path liquid-based preparations and conventional smears was 82. 1% and 56. 0%,and the specificity was 87. 5% and 82. 5%,respectively. The combined specificity was 100. 0%. The positive predictive value of two methods combined was 96. 3% and 92. 8%,whereas the negative predictive value was 54. 9% and 31. 9%,respectively. The difference between the two methods was significant（ P〈 0. 05）.Conclusions LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary when the cytological diagnosis is obscure.
出处
《中国呼吸与危重监护杂志》
CAS
北大核心
2016年第3期275-278,共4页
Chinese Journal of Respiratory and Critical Care Medicine
