Diagnostic value of liquid-based cytology and smear cytology in pancreatic endoscopic ultrasound-guided fine needle aspiration: A meta-analysis

BACKGROUND Smear cytology(SC)using endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)is the established and traditional choice for diagnosing pancreatic lesions.Liquid-based cytology(LBC)is a novel alternative cytological method,however,the comparative diagnostic efficacy of LBC remains inconclusive.AIM To examine the diagnostic efficacy of LBC and SC for pancreatic specimens obtained through EUS-FNA via a systematic review and meta-analysis.METHODS A systematic literature search was performed using PubMed,EMBASE,the Cochrane Library,and Web of Science.The numbers of true positives,false positives,true negatives,and false negatives for each cytological test(LBC and CS)were extracted from the included studies.The pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve(AUC)were calculated,and the AUC was compared by Tukey's multiple comparisons test.The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies II tool.RESULTS A total of 1656 patients in eight studies were included.The pooled sensitivity and specificity and the AUC for LBC were 0.76(95%CI:0.72-0.79),1.00(95%CI:0.98-1.00),and 0.9174,respectively,for diagnosing pancreatic lesions.The pooled estimates for SC were as follows:Sensitivity,0.68(95%CI:0.64-0.71);specificity,0.99(95%CI:0.96-100.00);and AUC,0.9714.Similarly,the corresponding values for LBC combined with SC were 0.87(95%CI:0.84-0.90),0.99(95%CI:0.96-1.00),and 0.9894.Tukey’s multiple comparisons test was used to compare the sensitivities and AUCs of the three diagnostic methods;statistically significant differences were found between the three methods,and LBC combined with SC was superior to both LBC(P<0.05)and SC(P<0.05).The pooled sensitivity and AUC did not change significantly in the sensitivity analysis.CONCLUSION LBC may be sensitive than SC in the cytological diagnosis of pancreatic lesions,however,the superior diagnostic performance of their combination emphasizes their integrated usage in the clinical evaluation of pancreatic lesions.

Comparison of smear cytology with liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

BACKGROUND Endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)is a safe and accurate technique to confirm the diagnosis of pancreatic cancers.Recently,numerous studies comparing the diagnostic efficacy of smear cytology(SC)and liquid-based cytology(LBC)for pancreatic lesions yielded mixed results.AIM To compare and identify the better cytology method for EUS-FNA in pancreatic lesions.METHODS A comprehensive search of PubMed,Embase,and Cochrane was undertaken through July 18,2020.The primary endpoint was diagnostic accuracy(sensitivity and specificity).Secondary outcomes included sample adequacy and post procedure complications.In addition,factors affecting diagnostic efficacy were discussed.RESULTS Data on a total of 1121 comparisons from 10 studies met the inclusion criteria.Pooled rates of sensitivity for SC and LBC were 78%(67%-87%)vs 75%(67%-81%),respectively.In any case,both SC and LBC exhibited a high specificity close to 100%.Inadequate samples more often appeared in LBC compared with SC.However,the LBC samples exhibited a better visual field than SC.Very few post procedure complications were observed.CONCLUSION Our data suggested that for EUS-FNA in pancreatic lesions(particularly solid lesions),SC with Rapid On-Site Evaluation represents a superior diagnostic technique.If Rapid On-Site Evaluation is unavailable,LBC may replace smears.The diagnostic accuracy of LBC depends on different LBC techniques.

Comparative Study of Cell Findings by Conventional Smear and Liquid-Based Cytology for Oral Exfoliative Cytology

Background: Liquid-based cytology (LBC) is a method of manufacturing cyto-diagnostic specimens. Improved accuracy is expected from standardizing specimen production and use of this method is rapidly spreading in oral cytology. On the other hand, LBC reportedly requires training to show peculiar cell findings compared to those of conventional smear cytology (CVC). Few studies have compared detailed cell findings for oral CVC and LBC. Objectives: The aim of this study was to compare cytological findings between CVC and LBC using cytomorphological image analysis. Materials and Methods: Cytological specimens were collected from 20 patients (negative for squamous neoplasia in 10, dysplasia in 5, squamous cell carcinoma in 5) and 5 controls of the tongue between January 2017 and December 2018. Two different preparation techniques were investigated cytomorphologically for CVC and LBC (BD CytorichTM). Results: LBC showed significantly higher cell numbers than CVC for all lesions. LBC-to-CVC ratio ranged from 9.52 (hyperkeratosis) to 1.87 (deep cells in oral squamous cell carcinoma (OSCC)). Nuclear area of normal, hyperkeratosis, and inflammation were significantly higher in LBC than those of CVC. Hyperchromasia was significantly more frequent with CVC than with LBC for hyperkeratosis, inflammation, dysplasia and OSCC. There was no significant difference in circularity between CVC and LBC among all lesions. Conclusion: Only one cytomorphological disadvantage was seen with LBC, in the form of decreased hyperchromasia. Further clarification of the advantages and disadvantages of LBC is needed, including management of precision and screening practices.

Vaginal Intraepithelial Neoplasia Detected with Cervical Liquid-Based Cytology: Old Concerns or New Facilities?

Background: The detection of vaginal intraepithelial neoplasia (VAIN) in cervical samples is not a common finding. Therefore, we aimed to report VAINs detected in liquid-based cytology (LBC) from women examined at Hospital das Clínicas of Faculty of Medicine, Sao Paulo State University. Materials and Methods: We evaluated LBC samples from women referred to gynecology examination for different reasons (previous abnormal PapTest, follow up of treated cervical lesion, ecc) and women examined for regular screening proposals, and compared with biopsy diagnoses, including the controversial diagnoses of vaginal intraepithelial neoplasia (VAIN). Results: From 1866 patients, 1423 (76.3%) cases were negative and 443 (23.7%) were positive for any cellular alteration. Age of patients ranged from 12 to 86 years. We detected 25 histologically confirmed VAIN (1.3% p = 0.0002 by Fisher’s exact test IC 95% 0.0090 - 0.0198) and 1.1% VAIN (p = 0.0031 by Fisher’s exact test IC 95% 0.0077 - 0.0179). Conclusion: The identification of VAIN in routine is feasible;the professionals involved with cytological examination should be aware of these lesions in Pap test samples.

Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles

AIM To evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques.METHODS From July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) with 22-gauge needles were retrospectively evaluated. EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up. Cytological specimens were characterized for cellularity and blood contamination. The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-m L/10-m L/20-m L syringes were analyzed.RESULTS Of all of the EUS-FNA procedures, the slow-pull technique and suction techniques with 5-m L/10-m L/20-m L syringes were used in 31, 19, 34 and 18 procedures, respectively. There were significant differences between these four suction techniques in terms of cytological diagnostic accuracy(90.3% vs 63.2% vs 58.8% vs 55.6%, P = 0.019), sensitivity(88.2% vs 41.7% vs 40.0% vs 36.4%, P = 0.009) and blood contamination(score ≥ 2 for 29.0% vs 52.6% vs 70.6% vs 72.2%, P = 0.003). The accuracy and sensitivity of the slow-pull technique were significantly higher than those of the suction techniques using 5-m L(P = 0.03, P = 0.014), 10-m L(P = 0.005; P = 0.006) and 20-mL syringes(P = 0.01, P = 0.01). Blood contamination was significantly lower in the slow-pull technique than in the suction techniques with 10-m L(P = 0.001) and 20-mL syringes(P = 0.007).CONCLUSION The slow-pull technique may increase the cytological diagnostic accuracy and sensitivity with slight blood contamination during EUS-FNA when using 22-gauge needles for solid pancreatic masses.

Research of cervical cytology screening in diagnosis of 370,000 cases with cervical lesion in Guangdong

Objective： Analysis of the results of 37 million cases by using cervical liquid-based cytology screening, discussion the situation of cervical cancer and precancerous lesions in Guangdong province. Methods： From 2002 to 2006, using liquid-based thin-layer cytology （TCT） method screening cervical lesions within 371,929 women in Guangdong. Cytological diagnosis adopt TBS （the Bethesda system） Standard （TBS improved 2001 version of the diagnostic criteria）, statistic positive rate by age and region respectively. Results： 371,929 cases of gynecology cervical samples in Guangdong, 331,251 cases were negative, accounted for 91.23%; cytology positive cases： 32,548 cases were squamous intraepithelial lesions （8.96%）, 486 cases were glandular epithelial lesions （0.13%）; grouped according to age： 30 to 40-year-old positive rate was 9.13%, 40 to 50-year-old positive rate was 9.60%, the latter had higher cytology positive rate; grouped according to region： the total samples in PRD areas were 304.951 cases, accounted for 81.99%, in which 24301 cases were positive （8.14%）, in 66978 cases （18.01%） of NON-PRD regions, 7645 cases were positive （11.87%）, there were 1858 cases had biopsy/follow-up results from 2004 to 2005, and the rate was 2.88%. Conclusion： The cytological positive rate of cervical cancer and its precancerous lesions was 9.09% in Guangdong （of which the rate of cytological diagnosis as precancerous lesions was 3.40%）, 30 to 50 age group had the high incidence of cervical cancer and its precursor lesions, and also the main stage of prevention for cervical cancer. Cytology positive rate was 11.87% in economic underdevelopment Non-Pearl River Delta regions, much higher than the Pearl River Delta region.

不同穿刺针和细胞学制片方法对甲状腺结节细针穿刺取材效果的影响

目的分析不同的甲状腺穿刺针联合不同细胞学制片方法对甲状腺结节细针穿刺取材效果的影响,寻找甲状腺细针穿刺细胞学检查的最佳模式。方法选择2020年6月至2021年8月在安徽医科大学附属滁州医院行超声引导下甲状腺细针穿刺细胞学检查的240例患者,分为4个组:注射器穿刺+常规涂片细胞学检查组、注射器穿刺+液基细胞学检查组、吸引活检针穿刺+常规涂片细胞学检查组、吸引活检针穿刺+液基细胞学检查组,比较4组患者细胞学诊断报告中不能诊断/不满意(取材失败)发生率以及穿刺并发症、穿刺疼痛程度。结果(1)4组间取材结果差异有统计学意义(P<0.05);进一步分析显示,注射器+液基的取材失败率较注射器+常规涂片组低(P<0.05),其他组别之间取材失败率差异无统计学意义。(2)注射器穿刺组和吸引活检针穿刺组取材结果差异无统计学意义(χ^(2)=0.144,P=0.704);常规涂片组取材失败率高于液基组(χ^(2)=5.192,P=0.023)。(3)按照结节弹性评分分层分析:当弹性评分2分时,注射器穿刺组取材失败率高于吸引活检针穿刺组(χ^(2)=5.103,P=0.024);当弹性评分>2分时,2种穿刺针取材失败率差异无统计学意义(χ^(2)=1.305,P=0.254)。(4)按照结节血流强度分层分析:当血流强度>1级时,常规涂片组取材失败率高于液基细胞学组(P=0.006)。(5)4组间疼痛评分差异有统计学意义(P=0.015),注射器穿刺组疼痛评分高于吸引活检针穿刺组(χ^(2)=3.165,P=0.002)。(6)穿刺并发症情况:注射器+常规涂片组发生1例局部血肿和1例低血压,吸引活检针+常规涂片组发生1例低血压,其余2组无并发症发生。结论注射器和吸引活检针取材结果整体上无差异。根据甲状腺结节的超声报告选择穿刺及制片方法可提高成功率。

细胞学涂片在肺结节术中的快速病理诊断价值

目的探讨细胞学涂片在肺结节术中的快速病理诊断价值。方法对胸腔镜手术术中送检的40例肺结节标本进行细胞学涂片,迪夫快速染色,光镜下观察,即时报告结果;与术中冷冻切片和术后石蜡切片结果进行对照。以术后石蜡切片诊断结果作为金标准,细胞学涂片和冷冻切片诊断结果分为确诊、误诊和延迟诊断,计算诊断准确度。结果在40例肺结节标本中,石蜡切片诊断腺癌28例,鳞癌2例,肺错构瘤1例,硬化性肺细胞瘤1例,肉芽肿病变3例,机化性病变或炎性病变5例;细胞学涂片确诊38例,准确率95.0%,1例误诊,1例延迟诊断;冷冻切片确诊39例,准确率97.5%,1例延迟诊断;细胞学涂片与冷冻切片检查对术中肺结节的诊断准确度差异无统计学意义(χ^(2)=0.000,P=1.000)。结论细胞学涂片检查在肺结节的术中快速病理诊断中有较高的准确率,具有临床实用价值。

Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.

Study on the Correlation between Human Papillomavirus and Mycoplasma genitalium Combined with TCT Detection

Objective: This study aims to explore the correlation between human papillomavirus (HPV) and Mycoplasma genitalium (CT) combined with TCT detection in cervical cancer screening. Method: A cross-sectional study design was adopted, and a total of 609 women who came to seek medical treatment were recruited as the study subjects. Combination testing was evaluated on cervical cancer screening by testing the women for HPV, CT with TCT detection and analyzing the relationship of cervical lesions with HPV and CT infection. Results: The study results showed that 21.57% of the subjects were infected with both HPV and CT, and 48.42% of the cases had abnormal TCT results at the same time. Further data analysis showed that HPV infection was significantly associated with abnormal TCT outcomes (p < 0.05), suggesting a possible synergistic effect of the two infections in cervical lesions. The combined sensitivity and specificity of HPV, CT and TCT detection were 21.57% and 48.42%, respectively, which were significantly higher than that of single detection. Conclusion: In summary, the results of this study support the importance of combined HPV, CT, and TCT testing in cervical cancer screening, and propose the hypothesis that combined testing may improve screening effectiveness. However, further large sample studies are needed to confirm this conclusion and explore the prospects of combined testing in clinical practice.

宫颈脱落细胞特殊染色技术在宫颈病变筛查中的应用价值

目的:探讨宫颈脱落细胞特殊染色技术在宫颈病变筛查中的临床应用价值。方法:选取2022年8月-2023年5月在山东第二医科大学附属医院及潍坊市人民医院进行宫颈病变筛查的女性共2000例,所有对象均进行宫颈脱落细胞特殊染色技术(FRD)检测、人乳头瘤病毒(HPV)和液基薄层细胞(TCT)检测。3种筛查方法任一结果阳性病例行阴道镜检查,阴道镜下有病变者行宫颈活检。以宫颈组织病理结果为金标准,比较FRD、TCT、HPV、HPV+TCT组的检测效能及受试者工作特征曲线下面积(AUC)。结果:FRD检测灵敏度为83.8%、特异度为90.0%,Kappa值为0.618,AUC为0.869;TCT检测的灵敏度为65.1%、特异度为89.5%,Kappa值为0.485,AUC为0.773;HPV检测的灵敏度为94.6%、特异度为71.7%,Kappa值为0.387,AUC为0.832;HPV+TCT联合检测的灵敏度为98.9%、特异度为70.2%,Kappa值为0.391,AUC为0.846。结论:宫颈脱落细胞特殊染色试验用于宫颈病变筛查有较好的效果,可用于基层宫颈病变筛查。

Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions

Background： Liquid-based cytology （LBC） offers an alternative method to biopsy in screening endometrial cancer. Cell block （CB）, prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions. Methods： A total of 198 women with high risks of endometrial carcinoma （EC） from May 2014 to April 2015 were enrolled in this study. The cytological specimens were collected by the endometrial sampler （SAP-1 ） followed by histopathologic evaluation of dilatation and curettage or biopsy guided by hysteroscopy. The residual cytological specimens were processed into paraffin-embedded CB after LBC preparation. Diagnostic accuracies of LBC and CB for detecting endometrial lesions were correlated with histological diagnoses. Chi-square test was used to compare the specimen adequacies of LBC and CB. Results： The specimen inadequate rate of CB was significantly higher than that of LBC （22.2% versus 7.1%, P 〈 0.01）. There were 144 cases with adequate specimens for LBC and CB preparation. Among them, 29 cases were atypical endometrial hyperplasia （ 11 cases） or carcinoma （18 cases） confirmed by histology evaluation. Taking atypical hyperplasia and carcinoma as positive, the diagnostic accuracy of CB was 95.1% while it was 93.8% in LBC. When combined LBC with CB, the diagnostic accuracy was improved to 95.8%, with a sensitivity of 89.7% and specificity of 97.4%. Conclusions： CB is a feasible and reproducible adjuvant method for screening endometrial lesions. A combination of CB and LBC can improve the diagnostic accuracy of endometrial lesions.

Case Report:Liquid-based cytology aids in primary fallopian tube cancer diagnosis

Primary fallopian tube carcinoma(PFTC) is a rare malignant carcinoma among all genital tract malignancies.It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically.Because of its insidious onset and silent course,the diagnosis is made usually postoperatively.Liquid-based cytology(LBC) is a type of method for cervical cancer screening,but sometimes it may aid in making PFTC diagnosis.We report a 47-year-old woman with PFTC,whose diagnosis was made with the aid of LBC.

人乳头瘤病毒16/18阳性联合阴道镜检查在宫颈细胞学阴性宫颈病变诊断中的应用

目的观察人乳头瘤病毒(HPV)16/18阳性联合阴道镜检查在宫颈细胞学阴性的宫颈病变诊断中的应用。方法选取我院妇科门诊2018年6月至2021年6月收治的宫颈细胞学检测结果为阴性且HPV 16/18阳性结果的患者120例,所有患者均接受阴道镜检查及宫颈活检联合宫颈管搔刮术(ECC),以病理学诊断为标准,分析诊断效果。结果组织病理学结果显示,120例患者中宫颈炎85例(70.8%),宫颈上皮内瘤变(CIN)Ⅰ15例(12.5%),CINⅡ13例(10.8%),CINⅢ5例(4.2%),宫颈癌2例(1.7%)。120例宫颈细胞学检测结果为阴性且HPV 16/18阳性的患者中,HPV 16型感染90例(75.0%),HPV18型感染20例(16.7%),HPV16/18型同时阳性感染10例(8.3%)。90例HPV 16阳性患者中,宫颈炎72例,CIN 8例,CINⅡ6例,CINⅢ3例,宫颈癌1例;20例HPV 18阳性患者中,宫颈炎10例,CINⅠ5例,CINⅡ4例,CINⅢ1例,宫颈癌0例;10例HPV 16/18同时阳性患者中,宫颈炎3例,CINⅠ2例,CINⅡ3例,CINⅢ1例,宫颈癌1例。HPV 16/18 HPV同时阳性患者≥CINⅡ级比例为50.0%,高于HPV16/18单一阳性患者的11.1%和25.0%,差异具有统计学意义(P<0.05)。阴道镜诊断宫颈细胞学阴性、HPV 16/18阳性患者的宫颈病变准确率为95.0%,灵敏度为96.0%,特异度为85.5%。结论对于宫颈细胞学阴性、HPV 16/18阳性患者宜进一步行阴道镜宫颈活检,以减少宫颈高级别鳞状CIN甚至癌变的漏诊。

宫颈脱落细胞特殊染色技术筛查宫颈病变效果

目的:探讨宫颈病变筛查的宫颈脱落细胞特殊染色技术的临床应用效果。方法:选择2021年3月-2022年6月在本院及多家医疗中心行宫颈病变筛查的女性共1176例。进行宫颈癌筛查两项,即人乳头瘤病毒(HPV)+液基薄层细胞(TCT)和宫颈脱落细胞特殊染色实验检测,对筛查出的宫颈病变阳性病例,以阴道镜下宫颈活检病理结果为金标准,对宫颈病变筛查中HPV、TCT和宫颈脱落细胞特殊染色实验的临床应用效果对比分析。结果:3种宫颈癌筛查方式检出的阳性病例与病理学检查的一致率TCT检测(40.1%)>宫颈脱落细胞特殊染色实验(28.8%)>HPV检测19.6%(P<0.05)。宫颈脱落细胞特殊染色实验的灵敏度(62.1%)、准确度(80.1%)与TCT检测(53.8%、89.8%)无差异(P>0.05)。结论:宫颈脱落细胞特殊染色试验在宫颈病变筛查中灵敏度、准确度与TCT检测效果相当,且具有便携性高、操作简单、检测快速和经济实用等特点,适合基层宫颈癌筛查。

液基薄层细胞学AI诊断技术在宫颈病变病理诊断中的应用价值研究

目的分析液基薄层细胞学AI诊断技术在宫颈病变病理诊断中的应用效果。方法1000例于本院进行宫颈病变检查的患者为研究对象,所有患者均经巴氏涂片法检查、液基薄层细胞学检查,分析巴氏涂片法检查、液基薄层细胞学检查的涂片满意率与阳性符合率,比较人工阅片与AI阅片的检测效能。结果液基薄层细胞学检查的涂片满意率99.20%高于巴氏涂片法检查的87.70%,差异有统计学意义(P<0.05)。液基薄层细胞学阳性检出率48.50%(485/1000)高于巴氏涂片法的36.40%(364/1000),差异有统计学意义(P<0.05)。液基薄层细胞学检查阳性符合率75.05%(364/485)高于巴氏涂片法的40.38%(147/364),差异有统计学意义(P<0.05)。AI阅片的敏感性、阴性预测值显著高于人工阅片,特异性和阳性预测值明显低于人工阅片,两种方式联合阅片的特异性、敏感性、阴性预测值、阳性预测值均高于单独人工阅片或AI阅片。液基薄层细胞学涂片人工阅片每份所需时间为(6.48±0.63)min,AI阅片每份所需时间为(1.79±0.25)min,每份人工复核时间为(2.41±0.36)min。AI阅片所需时间明显短于单纯人工阅片,差异有统计学意义(P<0.05)。结论宫颈病变病理诊断中采用液基薄层细胞学诊断的阳性符合率显著高于巴氏涂片法检查,同时,在液基薄层细胞学诊断中联合AI诊断技术能明显提升诊断敏感性、特异度,并缩短阅片时间,值得在临床推广应用。

细胞蜡块抗酸染色在淋巴结结核诊断中的应用

目的:探讨淋巴穿刺液细胞蜡块抗酸染色在淋巴结结核诊断中的应用价值。方法:纳入赣州市第五人民医院2021年1月—2022年6月收治的100例疑似淋巴结结核患者。所有患者均采集淋巴结抽吸液标本,均行直接涂片及细胞蜡块抗酸染色、瑞氏-吉姆萨染色、结核分枝杆菌培养,以结核分枝杆菌培养结果为金标准,比较不同方法诊断淋巴结结核的价值。结果:100例患者经结核分枝杆菌培养确诊淋巴结结核38例(38.00%)。涂片抗酸染色法诊断准确度为73.00%,敏感度为34.21%,特异度为96.77%;细胞蜡块抗酸染色法诊断准确度为85.00%,敏感度为78.95%,特异度为88.71%;瑞氏-吉姆萨染色法诊断准确度为83.00%,敏感度为73.68%,特异度为88.71%。以上三种方法与金标准的一致性Kappa值分别为0.351、0.680、0.634。结论:淋巴结穿刺液细胞蜡块抗酸染色法在淋巴结结核诊断中具有较高的诊断效能,相较于传统的涂片抗酸染色法、瑞氏-吉姆萨染色法,其诊断准确度更高。

高危型HPV感染和宫颈癌前病变与阴道微生态的影响因素分析

目的探究高危型人乳头瘤病毒(HR-HPV)感染和宫颈癌前病变与阴道微生态的影响因素。方法选取250例疑似高危型HPV感染和宫颈癌前病变患者,均实施液基薄层细胞学检查(TCT)、HR-HPV筛查,以病理活检结果为金标准,统计宫颈癌前病变情况。将宫颈鳞状上皮内病变患者作为A组,无宫颈病变且HPV阴性者作为B组,实施阴道微生态检测,分析阴道微生态检测指标。结果250例疑似患者中,宫颈上皮内瘤样病变Ⅰ级69例,宫颈上皮内瘤样病变Ⅱ级54例,宫颈上皮内瘤样病变Ⅲ级40例,正常宫颈组织87例。A组乳酸杆菌、乳酸杆菌功能正常的检出率显著高于B组,差异有统计学意义(P<0.05)。两组试验者菌种多样性呈Ⅱ~Ⅲ级、菌群密集度呈Ⅱ~Ⅲ级、pH<4.5的检出率比较,差异无统计学意义(P>0.05)。A组细菌性阴道病、需氧菌性阴道病发生率均显著高于B组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:乳酸杆菌占比低、患有细菌性阴道病、需氧菌性阴道病是宫颈癌前病变的危险因素(P<0.05)。结论高危型HPV感染宫颈癌前病变患者的微生态异常的危险因素包括乳酸杆菌占比低、发生细菌性阴道病及需氧菌性阴道病,通过改善阴道微环境有助于预防宫颈病变。

多步法分离和纯化雪旺细胞的实验研究

目的 改进雪旺细胞（SCs）的体外培养条件,以获得足够数量较纯净的雪旺细胞应用于周围神经修复。方法 5-7 d的SD仔鼠坐骨神经,采用混合酶长时间多次消化法分离雪旺细胞,阿糖胞苷（cytosine arabinoside,Ara-C）、G418（geneticin）抑制成纤维细胞生长,氟丝扣林促进雪旺细胞分裂增殖,低浓度胰酶快速消化传代进一步纯化雪旺细胞。结果 使用上述方法可以获得大量的高纯度雪旺细胞,经抗S-100蛋白单抗通过SABC法染色鉴定,雪旺细胞纯度可达到97％以上。结论本文所使用的方法是培养和纯化雪旺细胞较为理想的方法,可以满足目前组织工程神经修复的需要。

新型隐球菌性脑膜炎

新型隐球菌系具有荚膜结构的酵母真菌,因其嗜中枢性而使中枢神经系统成为主要攻击部位,可通过跨细胞途径、细胞旁途径或"木马机制"突破血脑脊液屏障,引起致命性新型隐球菌性脑膜炎。获得性免疫缺陷综合征合并新型隐球菌性脑膜炎病死率可达10%～25%,至少有约1/3的患者经历抗菌药物治疗失败。因此了解其致病机制、尽快明确诊断、探索更为有效合理的治疗方案至关重要。