中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2012年
3期
181-185
,共5页
刘岩%徐美林%王菁%吴秉铨%钟镐镐%方伟岗
劉巖%徐美林%王菁%吳秉銓%鐘鎬鎬%方偉崗
류암%서미림%왕정%오병전%종호호%방위강
胸腔积液%端粒,末端转移酶%免疫组织化学
胸腔積液%耑粒,末耑轉移酶%免疫組織化學
흉강적액%단립,말단전이매%면역조직화학
Pleural effusion%Telomerase%Immunocytochemistry
目的 探讨端粒酶活性和免疫细胞化学技术在胸腔积液和支气管肺泡灌洗液的离心涂片细胞学诊断中的应用价值.方法 选择100例胸腔积液和23例支气管肺泡灌洗液样本,分别进行常规离心涂片细胞学诊断、荧光即时聚合酶链反应端粒酶活性检测和琼脂-石蜡双包埋切片免疫细胞化学染色,并对临床资料进行综合分析.结果 123例样本中,端粒酶阳性53例,阴性70例,细胞学阳性即有明确肿瘤细胞的涂片39例,细胞学阴性即未见肿瘤细胞的涂片64例,见有异形细胞的可疑涂片20例,两者结果不符的30例样本结合涂片免疫细胞化学染色和临床随访确定最终诊断.端粒酶检测符合率为87.0％,敏感性为83.0％,特异性为90.0％；细胞学涂片诊断符合率为82.1％,但存在16.3％的诊断灰区,如将两者结合,敏感性和特异性分别提高至97.6％和100.0％.结论 端粒酶活性检测和细胞沉淀双包埋切片的免疫细胞化学染色相结合对于体液中异形细胞的良恶性鉴别及恶性细胞组织来源判定具有较高的参考价值,提高了细胞学诊断的敏感性和特异性.
目的 探討耑粒酶活性和免疫細胞化學技術在胸腔積液和支氣管肺泡灌洗液的離心塗片細胞學診斷中的應用價值.方法 選擇100例胸腔積液和23例支氣管肺泡灌洗液樣本,分彆進行常規離心塗片細胞學診斷、熒光即時聚閤酶鏈反應耑粒酶活性檢測和瓊脂-石蠟雙包埋切片免疫細胞化學染色,併對臨床資料進行綜閤分析.結果 123例樣本中,耑粒酶暘性53例,陰性70例,細胞學暘性即有明確腫瘤細胞的塗片39例,細胞學陰性即未見腫瘤細胞的塗片64例,見有異形細胞的可疑塗片20例,兩者結果不符的30例樣本結閤塗片免疫細胞化學染色和臨床隨訪確定最終診斷.耑粒酶檢測符閤率為87.0％,敏感性為83.0％,特異性為90.0％；細胞學塗片診斷符閤率為82.1％,但存在16.3％的診斷灰區,如將兩者結閤,敏感性和特異性分彆提高至97.6％和100.0％.結論 耑粒酶活性檢測和細胞沉澱雙包埋切片的免疫細胞化學染色相結閤對于體液中異形細胞的良噁性鑒彆及噁性細胞組織來源判定具有較高的參攷價值,提高瞭細胞學診斷的敏感性和特異性.
목적 탐토단립매활성화면역세포화학기술재흉강적액화지기관폐포관세액적리심도편세포학진단중적응용개치.방법 선택100례흉강적액화23례지기관폐포관세액양본,분별진행상규리심도편세포학진단、형광즉시취합매련반응단립매활성검측화경지-석사쌍포매절편면역세포화학염색,병대림상자료진행종합분석.결과 123례양본중,단립매양성53례,음성70례,세포학양성즉유명학종류세포적도편39례,세포학음성즉미견종류세포적도편64례,견유이형세포적가의도편20례,량자결과불부적30례양본결합도편면역세포화학염색화림상수방학정최종진단.단립매검측부합솔위87.0％,민감성위83.0％,특이성위90.0％；세포학도편진단부합솔위82.1％,단존재16.3％적진단회구,여장량자결합,민감성화특이성분별제고지97.6％화100.0％.결론 단립매활성검측화세포침정쌍포매절편적면역세포화학염색상결합대우체액중이형세포적량악성감별급악성세포조직래원판정구유교고적삼고개치,제고료세포학진단적민감성화특이성.
Objective To evaluate the application of traditional cytomorphology,telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis of pleural effusion and bronchoalveolar lavage samples.Methods A total of 123 agar-paraffin double-embedded pleural effusion and bronchoalveolar lavage fluid samples were enrolled into study.The cytomorphologic features were reviewed and correlated with immunocytochemical findings and telomerase activity.Results Telomerase activity was detected in 53 specimens using the real-time telomeric repeat amplification protocol.Amongst the cases studied,39 samples (31.7％) contained overtly malignant cells while 20 cases (16.0％ ) were equivocal by conventional cytology.After verification by immunocytochemistry and clinical follow-up data,the diagnostic accuracy of telomerase activity and cytology was 87.0％ and 82.1％,respectively. The sensitivity (97.6％) and specificity (100.0％ ) of cytology examination,when combined with telomerase activity analysis,were greater than those of cytology examination or telomerase activity analysis alone.Conclusions Telomerase activity analysis can be used as an adjunctive investigative tool in cytology assessment of pleural effusion and bronchoalveolar lavage samples.The diagnostic accuracy can be further improved with the application of immunocytochemistry on agar-paraffin double-embedded cell block tissues.
