液基细胞学联合免疫细胞化学对肺腺癌胸腔积液的诊断价值
The diagnostic value of liquid-based cytology combined with immunocytochemistry for adenocarcinoma pleural effusion
纪燕英 1张娜娜 1高锦添 1方紫岑1
作者信息
- 1. 中山大学附属第三医院病理科,广州 510630
- 折叠
摘要
目的 研究液基细胞学联合免疫细胞化学染色对肺腺癌胸腔积液的诊断价值.方法 收集中山大学附属第三医院病理科2022年6月至2023年2月送检的50例胸腔积液样本,以细胞蜡块免疫组化作为诊断标准,其中30例确诊为肺腺癌,20 例为非腺癌积液(包括 17 例非肿瘤积液、2 例小细胞肺癌和 1 例肺鳞癌),均采用液基薄层制片技术中的沉降式液基薄层细胞制片技术(liquid-based cytology technology,LCT)和膜式薄层细胞制作技术(thinprep cytologic test,TCT)制片,行免疫细胞化学染色,比较分析液基细胞学免疫细胞化学染色的可行性.结果 液基细胞学联合免疫细胞化学诊断结果与细胞蜡块免疫组织化学诊断结果一致,但TCT制片法明显优于LCT制片法,样本间细胞数量一致,分布均匀,阳性染色定位准确,细胞质和细胞核呈色清晰.TTF-1、napsin A、CK7 在TCT联合免疫细胞化学检测肺腺癌的灵敏度分别 100%、91.66%、93.10%,特异性为100%、100%、83.33%;而P40在1例肺鳞癌中弥漫表达.结论 液基细胞学联合免疫细胞化学在胸腔积液肺腺癌的诊断中表现出较高的敏感性和特异性,在临床工作尤其是晚期患者原发灶难以获取的患者具有重要价值;因其操作时间短,在缩短报告时长方面更显示出巨大优势.
Abstract
Objective To study the diagnostic value of liquid-based cytology combined with immunocytochemical staining for lung adenocarcinoma pleural effusion.Methods Fifty pleural effusion samples sent for examination from June 2022 to February 2023 at the Department of Pathology,Third Affiliated Hospital of Sun Yat-sen University were collected.Immunohistochemistry on cell blocks was used as the diagnostic standard.Among these,30 cases were confirmed to be lung adenocarcinoma,and 20 cases were non-adenocarcinoma effusions(including 17 cases of non-tumor effusions,2 cases of small cell lung cancer,and 1 case of squamous cell lung cancer).All samples were prepared using sedimentation liquid-based thin layer cytology technology(LCT)and membrane thin layer cell preparation technology(thinprep cytologic test,TCT)for immunocytochemical staining.The feasibility of liquid-based cytology immunocytochemical staining was compared and analyzed.Results The diagnostic results of liquid-based cytology combined with immunocytochemical staining were consistent with the immunohistochemistry diagnosis of cell blocks.However,the TCT prepa-ration method was significantly better than the LCT method,with a consistent number of cells between samples,uniform distribution,accurate positive staining localization,and clear coloring of cytoplasm and nuclei.TTF-1,napsin A,CK7 showed sensitivities of 100%,91.66%,and 93.10%,respectively,and specificities of 100%,100%,and 83.33%,respectively,in the TCT combined immu-nocytochemical detection of lung adenocarcinoma;P40 was diffusely expressed in 1 case of squamous cell lung cancer.Conclusion Liquid-based cytology combined with immunocytochemistry shows high sensitivity and specificity in the diagnosis of pleural effusion in lung adenocarcinoma and is of significant value in clinical practice,especially for patients whose primary lesion is difficult to obtain,especially late-stage patients;due to its short operation time,it also shows a huge advantage in shortening the reporting time.
关键词
胸腔积液/液基细胞学/免疫细胞化学/肺腺癌/肺癌Key words
Pleural effusion/liquid-based cytology/immunocytochemistry/lung adenocarcinoma/lung cancer引用本文复制引用
基金项目
国家自然科学基金(81902416)
广东省自然科学基金(2018A0303130324)
出版年
2024
NETL
NSTL
万方数据