血性胸腔积液细胞块制作方法研究及其应用

Preparation method and application of cell block of bloody pleural effusion

目的:探讨一种适合血性胸腔积液的细胞块制作方法。方法:收集细胞学涂片中见到肿瘤细胞的血性胸水48例,分别用直接离心沉淀法、去红细胞离心沉淀法和富集有核细胞层沉淀法制作细胞块,对三种方法获得的细胞块的HE染色效果、免疫组化效果及提取DNA的合格率进行比较。结果:直接离心沉淀法、去红细胞离心沉淀法、富集有核细胞层沉淀法制作细胞块的提取DNA合格率分别为72.9%(35/48)、85.4%(41/48)和93.8%(45/48),富集有核细胞层沉淀法提取DNA的合格率明显高于直接离心沉淀法,两者合格率差异有统计学意义(P<0.01)。富集有核细胞层沉淀法提取DNA的合格率高于去红细胞离心沉淀法,但两者合格率差异无统计学意义(P>0.05)。HE、免疫组化效果富集有核细胞层沉淀法最好,去红细胞离心沉淀法次之,直接离心沉淀法最差。结论:血性胸水细胞块推荐的方法依次是富集单个核细胞层沉淀法、去红细胞离心沉淀法、直接离心沉淀法。

Objective：To explore a method of making cell blocks suitable for bloody pleural effusion.Methods：Forty-eight cases of bloody pleural effusion of tumor cells were collected in the cytological smears,and the cell blocks were prepared by direct centrifugation method,removed red blood cells sedimentation method and enriched mononuclear cell layer method.The results of HE,immunohistochemistry and DNA extraction were compared in the three methods.Results：The qualified rate of DNA extraction solution of cell block in direct centrifugation method,removed red blood cells sedimentation method and enriched mononuclear cell layer method was 72.9%（35/48）,85.4%（41/48） and 93.8%（45/48） respectively.The qualified rate of the DNA extraction solution in enriched mononuclear cell layer method was significantly higher than that of the direct centrifugation method.There was significant difference between the two groups（P〈0.01）.The qualified rate of the DNA extraction solution in enriched mononuclear cell layer method was better than that of removed red blood cells sedimentation method.But there was no significant difference between the two groups（P〉0.05）.The effect of HE and immunohistochemistry on the enriched mononuclear cell layer method was the best,and the removed red blood cell sedimentation method was the second,and the direct centrifugation method was the worst.Conclusion：The recommended methods for the determination of bloody pleural effusion cells in order are the enriched mononuclear cell layer method,the removed red blood cells sedimentation method,the direct centrifugation method.