CAJ | 학술논문

目的探讨浆膜腔积液细胞块切片免疫细胞化学染色在细胞学诊断上的意义.方法收集2006年至2008年有间皮增生、异形细胞、癌细胞的浆膜腔积液99例,进行离心涂片、细胞块切片HE染色及免疫细胞化学染色,并结合临床及随访结果进行综合分析.结果本组病例涂片、细胞块切片HE染色、免疫细胞化学染色及综合诊断的阳性率、阴性率和不确定率依次为:涂片,68.7%(68/99)、16.2%(16/99)和15.1%(15/99);细胞块切片HE染色,71.7%(71/99)、16.2%(16/99)和12.1%(12/99);细胞块切片免疫细胞化学染色,76.8%(76/99)、20.2%(20/99)和3.0%(3/99);综合诊断,77.8%(77/99)、17.2%(17/99)、5.0%(5/99).涂片与细胞块切片HE染色检查结果的差异无统计学意义(P>0.05);涂片或细胞块切片HE染色检查与免疫细胞化学染色的不确定率差异均具统计学意义(P<0.05).涂片、细胞块切片HE染色检查的假阳性率、假阴性率均为0;免疫细胞化学染色的假阳性率、假阴性率均为1.0%(1/99).结论细胞块免疫细胞化学染色是诊断浆膜腔积液良恶性及判别瘤细胞组织来源的有效方法;结合涂片、切片之HE和免疫细胞化学染色及临床情况综合分析能提高积液诊断的阳性率.
목적 탐토장막강적액세포괴절편면역세포화학염색재세포학진단상적의의.방법 수집2006년지2008년유간피증생、이형세포、암세포적장막강적액99례,진행리심도편、세포괴절편HE염색급면역세포화학염색,병결합림상급수방결과진행종합분석.결과 본조병례도편、세포괴절편HE염색、면역세포화학염색급종합진단적양성솔、음성솔화불학정솔의차위:도편,68.7%(68/99)、16.2%(16/99)화15.1%(15/99);세포괴절편HE염색,71.7%(71/99)、16.2%(16/99)화12.1%(12/99);세포괴절편면역세포화학염색,76.8%(76/99)、20.2%(20/99)화3.0%(3/99);종합진단,77.8%(77/99)、17.2%(17/99)、5.0%(5/99).도편여세포괴절편HE염색검사결과적차이무통계학의의(P>0.05);도편혹세포괴절편HE염색검사여면역세포화학염색적불학정솔차이균구통계학의의(P<0.05).도편、세포괴절편HE염색검사적가양성솔、가음성솔균위0;면역세포화학염색적가양성솔、가음성솔균위1.0%(1/99).결론 세포괴면역세포화학염색시진단장막강적액량악성급판별류세포조직래원적유효방법;결합도편、절편지HE화면역세포화학염색급림상정황종합분석능제고적액진단적양성솔.
Objective To study the values of immunohistochemistry staining and cytological diagnosis by using cell block sections prepared with the effusion fluid cytology specimens. Methods Ninety- nine effusion cytology specimens with the diagnoses of reactive mesothelial hyperplasia, atypical cells and metastatic carcinoma were enrolled into the study. The cytospin preparations/smears, cell block sections and immunohistochemical study were performed and correlated with the clinical findings and follow-up data.Results Amongst the 99 cases studied, the percentage with positive diagnosis using cytospin preparations/smears was 68.7% (68/99). The percentages with negative and equivocal diagnoses were 16. 2% (16/99)and 15. 1% ( 15/99), respectively. As for cell block sections, the percentages were 71.7% (71/99),16. 2% (16/99) and 12. 1% (12/99), respectively. On the other hands, the percentages became 76. 8% (76/99), 20. 2% (20/99) and 3. 0% (3/99), respectively, when coupled with immunohistochemical findings. The overall percentages of positive, negative and equivocal diagnoses were 77.8% (77/99), 17.2% (17/99) and 5.0% (5/99), respectively, upon clinicopathologic correlation. The difference between cytespin preparations/smears and cell block sections was not statistically significant ( P > 0. 05 ). When coupled with immunohistochemical findings or clinicopathologic correlation, the difference in rates of equivocal diagnosis however carried statistical significance (P <0. 05 ) . The false-negative rate of immunohistochemical study applied on cell block sections was 1.0% (1/99). Conclusions Immunohistocbemistry, when applied on cell block sections, is useful in delineation of the primary origins of the tumor cells in effusion fluid cytology specimens. Combination of morphologic examination, immunohistochemical findings and clinicopathologic correlation can further improve the rate of positive diagnosis.