胸腔积液病理诊断中细胞蜡块技术与传统涂片技术的应用对比

Application Comparison of Cell Wax Block Technique and Traditional Smear Technique in Pathological Diagnosis of Pleural Effusion

目的以胸腔积液患者为研究对象,分析比较传统涂片技术与细胞蜡块技术在病理诊断中的效果。方法便利选取2019年6月—2021年4月该院接收的84例胸腔积液患者为研究对象,以数字号形式随机分组,即对照组(n=42)、观察组(n=42)。对照组患者采取传统涂片技术,观察组患者采取细胞蜡块技术。分析不同诊断方法的检查效果。结果在研究选取的84例患者中,男占63.10%,女占36.90%;年龄<65岁者占54.76%,年龄≥65岁者占45.24%;发病部位:右侧占52.38%,左侧占47.62%;血性胸腔积液占21.43%,非血性胸腔积液占78.57%;浑浊胸腔积液占82.14%,透明胸腔积液占17.86%。对照组恶性肿瘤细胞检出率为19.05%,明显低于观察组的54.76%,差异有统计学意义(P<0.05);对照组未检出肿瘤细胞所占比为50.00%,高于观察组的19.05%,差异有统计学意义(P<0.05)。对细胞蜡块诊断阳性标本34例,通过与免疫组织化学方法相结合,经采取标记发现,腺癌(64.71%)的占比最高,其次分别是无法确定(14.71%)、其他类型肿瘤(8.82%)、鳞癌(2.94%)、小细胞癌(2.94%)、恶性间皮瘤(2.94%)、恶性淋巴瘤(2.94%)。结论在病理诊断胸腔积液中细胞蜡块技术的应用能有效提高诊断准确率,使诊断治疗疗效提升,同时还能使胸腔积液细胞学诊断检出率及准确性提高,应用价值高。

Objective With pleural effusion as the study object,the effect of traditional smear technique and cell wax block technique in pathological diagnosis was analyzed and compared.Methods The 84 patients with pleural effusion received in the hospital from June 2019 to April 2021 were conveniently selected as study subjects.The selected cases were randomly divided into the study group in the form of numbers,namely the control group(n=42)and the observation group(n=42).The traditional smear technique was used for the control group and the cell wax block technique was used for the observation group.Analyzed the inspection effects of different diagnostic methods.Results Among the 84 patients selected in the study,63.10%were males and 36.90%were females.In the age range,54.76%of patients were younger than 65 years old,and 45.24%of patients were older than 65 years old.52.38%of patients had the right side and 47.62%had the left side.21.43%were bloody pleural effusions,and 78.57%were non-bloody pleural effusions.82.14%had cloudy pleural effusion,and 17.86%had transparent pleural effusion.The detection rate of malignant tumor cells in the control group was 19.05%,which was significantly lower than the 54.76%in the observation group,and the difference was statistically significant(P<0.05).The proportion of undetected tumor cells in the control group was 50.00%,which was higher than 19.05%in the observation group,and the difference was statistically significant(P<0.05).Diagnosis of 34 positive specimens of cell wax blocks were combined with immunohistochemical methods.After taking markers,it was found that adenocarcinoma(64.71%)had the highest proportion.Secondly,they were indeterminate(14.71%),other types of tumors(8.82%),squamous cell carcinoma(2.94%),small cell carcinoma(2.94%),malignant mesothelioma(2.94%),and malignant lymphoma(2.94%).Conclusion The application of cell wax block technology in pathological diagnosis of pleural effusion can effectively improve the diagnostic accuracy,improve the diagnostic and therapeutic effect,and at the same time increase the detection rate and accuracy of pleural effusion cytology,which has high application value.