液基细胞学及细胞蜡块联合免疫细胞化学检测在胸腹水细胞病理诊断中的临床价值

Clinical significance of liquid-based cytology and cell paraffin blocks combined with immunocytochemistry in cytopathologic diagnosis of hydrothorax and ascites

目的探讨液基细胞学、细胞蜡块联合免疫细胞化学检测在胸腹水细胞病理学诊断中的临床价值。方法收集114例胸腹水标本,比较液基细胞学和细胞蜡块联合免疫细胞化学两种方法的阳性检出率,对可疑阳性和阳性的病例做免疫细胞化学检测,进一步判断细胞的良恶性及组织来源。结果 114例胸腹水标本中,液基细胞学诊断阳性36例(31.58%),细胞蜡块联合免疫细胞化学诊断阳性55例(48.24%),差异有统计学意义(P<0.01)。55例恶性胸腹水,胸水45例,腹水10例;胸水中肺腺癌32例,小细胞肺癌3例,乳腺癌4例,子宫内膜癌1例,淋巴造血系统肿瘤1例,来源不明4例;腹水中卵巢癌2例,消化系统肿瘤1例,子宫内膜癌1例,淋巴造血系统肿瘤1例,来源不明5例。结论细胞蜡块联合免疫细胞化学可以明显提高胸腹水阳性检出率,并帮助判断组织来源。

Objective To investigate the clinical value of liquid-based cytology and cell paraffin blocks combined with immunocytoehemieal examination in cytopathologic diagnosis of hydrothorax and ascites. Methods One hundred and fourteen cases of hydrothorax and ascites sample were collected. The detection positive rates were compared between the liquid-based cytology and cell paraffin blocks combined with immunocyochemical examination. The suspected positive and positive cases were performed the immunocytoehemical examination for further judging benign and malignancy and histological source. Results 114 cases of hydrothorax and ascites samples, 36 cases（31.58%） of positive were diagnosed by liquid based eytologyamong and 55 eases（48.24 % ） of positive were diagnosed by cell paraffin blocks combined with immunocytochemical examination, the difference was statistically significant（P〈0.01）. There were 55 cases of malignant hydrothorax and ascites,45 cases were hydrothorax and 10 cases were ascites, in hydrothorax,there were 32 cases of lung adenocarcinoma,3 cases of small cell lung cancer,4 cases of breast cancer, 1 case of endometrial carcinoma, 1 case of lymphatic hematopoietic system tumor and 4 cases of unknown origin;in ascites, there were 2 cases of ovarian cancer, 1 case of digestive system tumor, 1 case of endometrial cancer, 1 case of lymphatic hematopoietie system tumor and 5 cases of unknown origin. Conclusion The cell paraffin blocks combined with immunocytochemistry can significantly improve the positive detection rate of hydrothorax and ascites,and helps to judge the source of tissue.