细胞印片技术在肺小结节术中快速病理诊断中的应用价值

Application of cell printing technique in rapid pathological diagnosis in pulmonary nodules

目的探讨细胞印片技术在肺小结节术中快速病理诊断中的应用价值。方法选取2019年5月至2020年5月于吉安市中心人民医院行肺小结节手术治疗的80例患者作为研究对象,以常规外检病理诊断结果为金标准,术中分别予以细胞印片技术、快速石蜡切片行病理诊断,比较不同检查方法的制片时间、染色效果及诊断效能,分析两种检查方法染色图的印片显像情况。结果细胞印片技术制片时间短于快速石蜡切片,染色效果评分低于快速石蜡切片,差异有统计学意义(P<0.05)。80例肺小结节患者中,常规外检病理检出恶性64例,良性16例;细胞印片技术诊断准确率为87.50%、灵敏度为92.19%、特异度为68.75%,快速石蜡切片诊断准确率为90.00%、灵敏度为90.63%、特异度为87.50%,两种检查方法诊断准确率、灵敏度和特异度比较差异无统计学意义。细胞印片技术镜下恶、良性病变区分明显,恶性病变可见较多数量的细胞脱落,且形态呈畸形变化,印片背景较为浑浊,有颗粒感;良性病变可见细胞成熟分化,数量少且形态大小均匀,印片背景清晰。快速石蜡切片镜下恶性病变细胞形态不规则,细胞核大小不一,染色质不均、排列紊乱,不规律,细胞数量多,分布密集;良性结节细胞形态规则,细胞核大小均匀、染色质均匀、排列整齐、规律,其细胞数量少,分布稀疏。结论细胞印片技术用于肺小结节术中快速病理诊断中,有助于缩减操作时间,且具有良好染色效果,恶、良性病变所见细胞组织变化明显,便于临床精准鉴别患者组织病变类型,临床应用价值较高。

Objective To explore the value of cell printing technique in rapid pathological diagnosis of pulmonary nodules.Methods 80 pa-tients who underwent surgical treatment for small pulmonary nodules in Ji'an Central People's Hospital from May 2019 to May 2020 were selected as the study subjects,with the pathological diagnosis results of routine external examination as the gold standard,the cell printing technology and rapid paraffin section were respectively used for pathological diagnosis during the operation,the preparation time,staining effect and diagnostic effi-ciency of different detection methods were compared,and the printing imaging of the staining images of the two detection methods were analyzed.Results The preparation time of cell printing technology was shorter than that of rapid paraffin sections,and the staining effect score was lower than that of rapid paraffin sections,the difference was statistically significant(P<0.05).Among the 80 patients with small pulmonary nodules,64 cases were malignant and 16 cases were benign by routine external examination;the diagnostic accuracy,sensitivity and specificity of cell printing technology were 87.50%,92.19%and 68.75%,and the diagnostic accuracy,sensitivity and specificity of rapid paraffin section were 90.00%,90.63%and 87.50%,respectively,there was no statistical significance in the diagnostic accuracy,sensitivity and specificity between the two detec-tion methods.Under cell printing technology microscope,the distinction between malignant and benign lesions is obvious,malignant lesions showed a greater number of cells shedding,and morphological changes,the print background is relatively cloudy,have a granular feeling;benign le-sions showed cell mature mature differentiation,small number and uniform morphology,the print background is clear.Under rapid paraffin section microscope,the malignant cells were irregular in shape,different in nuclear size,uneven,disordered and irregular in chromatin,with large number of cells and dense distribution.Benign nodular cells have regular morphology,uniform nuclear size,uniform chromatin,orderly and regular arrange-ment,and small number and sparse distribution of cells.Conclusion Cell printing technology is used for rapid pathological diagnosis of small pul-monary nodules,which helps to reduce the operation time and has good staining effect,the cell tissue changes of malignant and benign lesions are ob-vious,which is convenient to accurately identify the tissue lesion types of patients,and has high clinical application value.