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目的探讨细胞块辅助支气管刷检液基细胞学在肺癌分型诊断中的应用。方法收集支气管刷检液基细胞学制片后剩余标本制备细胞块,应用免疫细胞化学检测Napsin A、TTF-1、p40、CD56在肺癌中的表达。结果43例肺癌中腺癌22例,鳞状细胞癌15例,小细胞癌6例。Napsin A诊断腺癌的敏感性和特异性分别为77.3%和100%;TTF-1诊断腺癌的敏感性和特异性分别为86.4%和75.0%;p40诊断鳞状细胞癌的敏感性和特异性分别为93.3%和100%;TTF-1诊断小细胞癌的敏感性和特异性分别为100%和48.6%;CD56诊断小细胞癌的敏感性和特异性分别为100%和91.9%。结论利用支气管刷检液基细胞学剩余标本制备细胞块,选择敏感性及特异性高的抗体进行标记,可提高细胞学在肺癌分型诊断的准确性。
Objective To investigate the application of cell-assisted bronchial brush-based liquid cytology in the diagnosis of lung cancer. Methods The bronchial brush test was used to collect cell mass after preparation of liquid-based cytology. Immunocytochemistry was used to detect the expression of Napsin A, TTF-1, p40, and CD56 in lung cancer. Results Of the 43 lung cancers, 22 were adenocarcinoma, 15 were squamous cell carcinoma, and 6 were small cell carcinoma. The sensitivity and specificity of Napsin A in the diagnosis of adenocarcinoma were 77.3% and 100%, respectively; the sensitivity and specificity of TTF-1 in the diagnosis of adenocarcinoma were 86.4% and 75.0%, respectively; the sensitivity and specificity of p40 in the diagnosis of squamous cell carcinoma. Their respective sensitivities were 93.3% and 100%; the sensitivity and specificity of TTF-1 in the diagnosis of small cell carcinoma were 100% and 48.6%, respectively; the sensitivity and specificity of CD56 in the diagnosis of small cell carcinoma were 100% and 91.9%, respectively. [Conclusion] The use of bronchial brush to detect the cell-based cytological residual specimens for preparation of cell masses, and selection of antibodies with high sensitivity and specificity for labeling can improve the accuracy of cytology in lung cancer classification diagnosis.