液基细胞学检查在恶性胸腹水鉴别诊断中的临床应用

Liquid based cytology in the diagnosis of malignant chest water to identify clinical application

目的探讨液基细胞学在检查恶性胸腹水鉴别诊断中的临床应用价值。方法将69例恶性胸腹水患者随机分为观察组和对照组,观察组进行液基细胞学检查,对照组进行传统细胞学检查。比较两组在制片效果的满意度和检测结果准确度方面的差异。结果 (1)传统细胞学制片镜下观察阳性细胞少而分散,分布厚薄不均,背景不清晰,有残存的红细胞和渗出物干扰实验结果;而相比之下液基细胞学检查法制片阳性细胞多而集中,细胞单层、均匀分布,不重叠,背景干净清晰。液基细胞学检查法的满意度(95.31%)远高于传统细胞学检查法的满意度(85.79%),差异有统计学意义(P<0.05);(2)在总共69例胸腹水标本中,液基细胞学检查法阳性率为27.38%(确诊病例和可疑病例),传统细胞学检查阳性率为24.42%,传统细胞学检查法检出率略低,但差异无统计学意义。结论液基细胞学检查法对胸腹水检查质量的满意度优于传统细胞学检查法,对恶性胸腹水的诊断检出率略高于传统细胞学检查法。

Objective To investigate the clinical value of liquid-based cytology in the differential diagnosis of malignant pleural effusion. Methods Sixty-nine patients with malignant pleural effusion and ascites were randomly divided into observation group and control group. Liquid- based cytology was performed in the observation group and conventional cytology was performed in the control group. The difference between the two groups in the satisfaction of the film production and the accuracy of the test results was compared. Results （The results of microscopic obser- vation of traditional cytology showed that the number of positive cells was small and scattered, the distribution of thickness was not uniform, the background was not clear, and the residual erythrocytes and exudate interfered with the experimental results; in contrast, liquid-based cytology Legal positive and more positive cells, concentrated, single cell layer, evenly distributed, non-overlapping background clean and clear. The satisfaction rate of liquid-based cytology （95.31%） was much higher than that of conventional cytology （85.79%）, and there was statistical significance（P〈0.05）. ② In a total of 69 samples of pleural effusion and ascites, the positive rate of liquid-based cytology was 27.38% （confirmed cases and suspicious cases）. The positive rate of traditional cytology was 24.42%, but the detection rate of traditional cytology was slightly lower, but the difference was not statis- tically significant. Conclusion Liquid-based cytology is superior to traditional cytology in examining the quality ofpleural and ascitic fluid. The detection rate of malignant pleural effusion is slightly higher than that of traditional cytology.