结核性积液细胞学图文报告结果评价

Evaluation on the cytological graphic report results of tuberculous effusion

目的分析结核性积液临床诊断结果与细胞学图文报告结果之间的关系,探讨结核性积液细胞学图文报告的意义。方法选取被临床确诊为结核性积液的患者224例,其中图文报告未能提示结核性积液82例。分析224例患者淋巴细胞(LY)、巨噬细胞(Ma)、中性粒细胞(NE)、间皮细胞(Me)等变化。结果LY<60%的临床诊断阳性符合率为39.4%,LY≥80%的临床诊断阳性符合率为78.8%。细胞图文报告未能提示结核性积液患者占总数的36.6%,漏诊原因以出血稀释或淋巴细胞偏少为主,其次是存在核异质细胞干扰和其他类型细胞增多。结论与临床诊断结果比较,细胞学图文报告能更好地揭示结核性积液细胞学变化特性,可为结核性积液临床诊断和发病机制研究提供新思路。

Objective To analyze the relation of tuberculous effusion diagnosed by clinic and the results of graphic report,and to investigate the clinical role of graphic reports indicating tuberculous effusion.Methods With the changes of lymphocyte(LY),macrophage(Ma),neutrophil(NE)and mesothelial(Me)cell,224 cases of clinically confirmed tuberculous effusion and 82 cases with graphic reports which could not indicate tuberculous effusion were analyzed.Results The positive coincidence rate with clinical diagnosis increased from 39.4%in low value group(LY<60%)to 78.8%in high value group(LY≥80%).There were the cases with graphic reports not indicating tuberculous effusion,accounting for 36.6%.The causes of missed diagnosis were mainly hemodilution or lack of LY,followed by the presence of nuclear heterogeneous cell interference and the increase of other types of cells.Conclusions The comparison of graphic report and clinical diagnosis can reveal the characteristics of cytological changes of tuberculous effusion,and provide a new idea for the clinical diagnosis of tuberculous effusion and the study of pathogenesis.