针吸细胞学在儿童体表恶性肿瘤诊断中的应用价值

Role of fine-needle aspiration cytology in diagnosis of malignant tumor in children

目的:探讨针吸细胞学(fine needle aspiration cytology,FNAC)在儿童体表恶性肿瘤诊断中的应用。方法:结合临床及组织病理学资料,回顾性分析2014年1月至2017年11月徐州市儿童医院及徐州医学院附属医院16例患儿(0~16岁)体表可疑恶性肿瘤的FNAC诊断结果及细胞形态学特点。结果:FNAC共诊断儿童恶性肿瘤及可疑恶性肿瘤16例,经术后组织病理学证实为淋巴瘤3例,甲状腺乳头状癌3例,高分化滤泡癌1例,甲状腺癌转移1例,鼻咽癌转移3例,纤维肉瘤1例,横纹肌肉瘤1例,梭形细胞肉瘤1例,朗格汉斯细胞组织细胞增生症1例,黄色肉芽肿1例。本组病例中,出现1例假阳性的结果,即FNAC诊断为可疑恶性肿瘤细胞,而组织病理结果为黄色肉芽肿;1例恶性肿瘤的具体分型错误,即FNAC诊断为霍奇金淋巴瘤,组织病理证实为鼻咽部转移癌。其余14例结果均与组织病理结果一致。FNAC对儿童表浅可疑恶性肿瘤诊断的准确率为87.5%。结论:FNAC检查操作简单、损伤小、耗时少,且准确率较高,是一种有效的术前筛查儿童体表恶性肿瘤的诊断方法。

Objective： To investigate the application of fine needle aspiration cytology （FNAC） in the diagnosis of malignant tumors on children’s body surface. Methods： Combined with clinical and histopathological data, the cytological diagnosis and cytological characteristics of suspected malignant tumors in children （0–16 years old） from January 2014 to November 2017 were analyzed retrospectively. Results： A total of 16 cases of malignant tumor and suspected malignant tumor in children were diagnosed by needle aspiration cytology. There were 3 cases of lymphoma, 3 cases of papillary thyroid carcinoma, 1 case of highly differentiated follicular carcinoma, 1 case of thyroid carcinoma metastasis, 3 cases of nasopharyngeal carcinoma metastasis, 1 case of fibro sarcoma, 1 case of rhabdomyosarcoma, 1 case of spindle cell sarcoma, 1 case of Langerhans cell histiocytosis. In this group, there was a false positive result, that is, FNAC was diagnosed as suspicious malignant tumor cells, while the histopathological results were yellow granuloma. One case of malignant tumor was misdiagnosed as Hodgkin＇s lymphoma by FNAC and histopathology confirmed as nasopharyngeal metastatic carcinoma. The results of the other 14 cases were consistent with histopathological results. The accuracy of FNAC in diagnosis of superficial suspicious malignant tumor in children was 87.5%. Conclusion： FNAC is an effective method for preoperative screening of malignant tumors in children.