颈部淋巴结肿大细针穿刺中细胞块的应用分析

The diagnostic application of cell block from fine-needle aspiration in cervical lymphadenopathy

目的探讨细针穿刺细胞学检查(fine needle aspiration cytology,FNAC)联合细胞块(cell block,CB)切片及CB免疫组织化学(IHC)在颈部淋巴结肿大中的应用价值。方法采用一次性使用持续负压穿刺器对126例肿大淋巴结病灶获取样本,比较FNAC涂片、FNAC联合CB切片、FNAC涂片联合CB切片及IHC三种不同方式对颈部淋巴结肿大病灶的诊断准确率。结果126例样本中,不同组织来源的转移性腺癌显示相对特异的IHC标记。FNAC涂片联合CB切片及IHC联合诊断的正确率最高(84.9%)。结论 FNAC涂片联合CB切片及IHC的方式,对确定头颈部淋巴结肿大的原因及部分转移性腺癌的原发部位判断具有重要意义。

Objective To investigate the clinical value of the fine-needle aspiration cytology（FNAC） combined with cell block（CB） section and immunochemistry（IHC） in the diagnosis of cervical lymphadenopathy.Methods A total of 126 samples were obtained from patients with enlarged lymph node by fine-needle aspiration.The accuracy of the focus diagnosis of the cervical lymphadenopathy by FNAC smear,FNAC CB and CB IHC was compared.Results In present study,specific IHC markers of metastatic adenocarcinoma were found in different tissues.The diagnostic accuracy of FNAC smear combined with CB IHC was the best（84.9%）.Conclusion FNAC smear combined with CB IHC is of great significance in determining the causes of head and neck lymphadenopathy and the primary site of metastatic adenocarcinoma.