148例体表淋巴结针吸细胞学检查诊断分析

Diagnostic accuracy of fine needle aspiration biopsy of surface lymph node:a study of 148 cases

目的探讨体表淋巴结针吸细胞学检查诊断的准确率。方法用7号穿刺针获取148例体表淋巴结针吸细胞学标本,制备细胞涂片及细胞块并作出细胞学诊断,对148例中无法直接明确诊断的10例可疑恶性肿瘤(黑色素瘤、鳞状细胞癌、小细胞癌、甲状腺乳头状癌及非霍奇金淋巴瘤)加做免疫细胞化学(immunocytochemistry,ICC)标记后再做出细胞学诊断;148例体表淋巴结针吸细胞学与活检结果对照,分析针吸细胞学与活检结果的符合率并总结细胞学特点。结果 148例体表淋巴结针吸细胞学与活检结果符合率为95.95%,细胞块镜下特点与组织学相似;148例体表淋巴结针吸细胞学中的10例可疑恶性肿瘤通过ICC标记后明确诊断。结论体表淋巴结针吸细胞学诊断准确率较高,细胞涂片结合细胞块、ICC可对淋巴结恶性肿瘤作出较准确的定性及分类诊断。

Objective To study the diagnostic accuracy of fine needle aspiration biopsy of surface lymph nodes.Methods 148 patients with surface lymph node obtained by 7fine needle aspiration were collected to make cell smear and cell block.10 cases of suspicious for malignancy such as Lymph node metastatic melanoma,squamous cell carcinoma,small cell carcinoma,papillary thyroid carcinoma and non-hodgkin lymphoma were diagnosed by immunocytochemistry,which based on cell block.Then,the agreement rate of needle aspiration cytology with the histology diagnosis and cytological characteristics were observed.Results The concordance rate between the cytologic and corresponding histologic diagnoses was 95.95%.10 cases of suspicious for malignancy were confirmed by immunocytochemistry.ConclusionsFine needle aspiration biopsy of surface lymph node carries a high diagnostic accuracy.For detailed subtyping of certain disease entities,cell block combined with Immunocytochemistry is required.