针吸液基薄片与传统涂片的对比研究

A comparison of Thinprep and conventional smears

目的 探讨液基薄片 (TP)在针吸细胞学中的应用前景。方法 乳腺、转移癌、淋巴结、涎腺及其他部位标本 5 2 2例 ,做传统涂片 (CS)和TP各 1张 ,HE染色。从涂片质量、细胞量及异常细胞量、细胞保存及形态结构、背景材料等几方面比较两种涂片。结果 乳腺组涂片质量TP略优于CS ,但差异无显著性 (P >0 .0 5 ) ;细胞量及异常细胞量二者相当 ;细胞保存及形态结构TP优于CS(P <0 .0 5 )。常见的乳腺纤维腺瘤 ,除了双极裸核变少、乳头片段变小外 ,TP涂片中细胞排列比在CS中平铺 ,更易诊断良性病变。转移癌组涂片质量TP优于CS(P <0 .0 5 ) ;细胞量及异常细胞量两者差异不大 (P >0 .0 5 ) ;细胞保存及形态结构TP优于CS (P <0 .0 5 )。淋巴结组涂片质量CS优于TP ,差异有显著性 (P <0 .0 5 ) ,CS优于TP的 4 6例中 ,2 7例为结核 ;细胞保存及形态结构二者差异不大 (P >0 .0 5 ) ;细胞量及异常细胞量TP劣于CS (P <0 .0 5 )。涎腺及其他部位组涂片质量TP与CS相当 ;细胞保存及形态结构、细胞量及异常细胞量等 ,差异均无显著性 (P >0 .0 5 )。结论 对于乳腺及转移癌病变 ,TP可单独应用 ;对于淋巴结及涎腺病变 ,TP应有CS作对照。

Objective To analyze ThinPrep (TP) application by comparing TP slides with conventional smear(CS) slides in fine needle aspiration cytology. Methods A total of 522 samples from the breast, metastatic cancer, lymph node, thyroid and salivary gland were used in parallel preparations of one TP slide and one CS slide. The paired slides were compared according to cell quality, overall cellularity, cell preservation, nuclear architecture and background. Results Cell quality of TP was superior to CS in the breast group(36.2%, 28.0%,P>0.05) and metastatic cancer group(51.0%, 14.9%,P<0.05), but inferior to CS in lymph node group(16.5%, 58.2%, P>0.05). Cellularities of TP and CS were similar in breast groups (25.1%), while TP had greater cellularity than CS in metastatic cancer group(32.2%, 21.8%,P>0.05). Cell preservation and abnormal architecture of TP were superior to CS in breast group(36.7%, 12.1%, P<0.05) and metastasis cancer group(60.9%, 9.4%, P<0.05). Cell quality of TP slide was inferior to CS in lymph node group (16.5%, 58.2%, P<0.05) with 27 of the 46 cases showing tuberculosis. Cell quality of TP and CS slide was similar in the thyroid and salivary gland group(35.3%). Myoepithelial cells of fibroadenoma on the TP slide were decreased in number and, due to the increased papillary and flattened cells, it was easy to diagnose benign lesion. Conclusion In the breast group and metastatic cancer group, cell quality of the TP slides is superior to CS, but they are similar in thyroid and salivary gland group. The difference of diagnosis criteria between TP and CS slides exists only in tuberculosis, partly the reactive hyperplasia cases.