摘要
目的研究经支气管针吸活检（TBNA）标本的细胞病理学特征，并与组织病理诊断结果比较分析，评估TBNA标本的细胞病理学诊断在肺癌诊断及分期中的作用。方法用TBNA方法21G针取材共374例，均经组织学明确诊断。根据针吸部位分为肺肿物组（65例）和淋巴结组（309例）。所有病例均直接涂片，并同时制作液基薄层涂片（LBT）。结果TBNA标本细胞病理学诊断肺癌的敏感性、特异性、假阳性率、假阴性率和准确性分别为95．7％（266／278）、100％（96／96）、0（0／96）、4．3％（12／278）和96．8％（362／374）。62．8％（167／266）的病例分型准确，包括95．7％（88／92）的小细胞癌、73．5％（25／34）的鳞状细胞癌和67．9％（53／78）的腺癌。细胞病理学对肺肿物TBNA与淋巴结TBNA诊断的准确性两者间差异无统计学意义（χ2=0．21，P〉0．05），对隆突下淋巴结TBNA与其他淋巴结TBNA诊断的准确性差异无统计学意义（χ2=0．08，P〉0．05）。直接涂片与LBT在TBNA中诊断的准确性差异无统计学意义（χ2=0．11，P〉0．05）。结论TBNA标本细胞病理学诊断癌的准确性和敏感性高，并可对大部分肿瘤准确分型。TBNA标本细胞病理学诊断的阳性结果可作为临床确诊肺癌及其分期的可靠依据。
Objective To study the cytopathologic features of transbronchial needle aspiration （TBNA） samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. Methods Three hundred seventy-four cytology specimens were collected by TBNA using 21-gauge needle, including 65 lung masses and 309 lymph nodes. Direct smears and liquid- based thin-layer preparations were performed for each case. The correlation between cytology and histopathologic diagnoses were analyzed. Results The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by TBNA was 95.7% （88/92） （266/278）, 100% （96/96）, 0（0/96）, 4. 3% （12/278） and 96.8% （362/374）, respectively. Overall 62. 8% （167/266） of the cases were precisely typed, including 95.7% （88/92） of small cell carcinoma, 73.5% （25/34） of squamous cell carcinoma and 67.9% （53/78） of adenocarcinoma. There was no statistical difference in the diagnostic accuracy of cytopathology between lung mass aspiration and mediastinal lymph node aspiration, as well as between subcarinal lymph node aspiration and other lymph node aspiration （ all P 〉 0. 05 ）. There was also no statistical difference in the diagnostic accuracy between direct smears and liquid-based preparations （ χ2 = 0. 11, P 〉 0. 05 ）. Conclusions Cytopathology of TBNA specimens is accurate and sensitive for diagnosing pulmonary carcinomas. In most cases, the lung carcinoma can be precisely typed. TBNA is useful for diagnosing and staging lung carcinomas.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2012年第6期400-404,共5页
Chinese Journal of Pathology
基金
北京大学肿瘤医院课题基金（课题号08-13）
