[应用积液细胞学标本制备的细胞块切片评估免疫组织化学染色及细胞学诊断]

[Evaluation of immunohistochemistry staining and cytologic diagnosis by using cell block sections prepared with effusion fluid cytology specimens].

作者信息

Mao Ying-yu, Yang Min, Liu Dong-ge, Lin Mao-hua, Zhang Li-qin, Chen Ze-qing

机构信息

Department of Pathology, Ningde City Mindong Hospital of Fujian Province, Fuan 355000, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2009 Aug;38(8):547-50.

PMID:20021967

Abstract

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 cytospin 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

Immunohistochemistry, 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.

摘要

目的

研究采用积液细胞学标本制备的细胞块切片进行免疫组化染色及细胞学诊断的价值。

方法

选取99例诊断为反应性间皮增生、非典型细胞及转移性癌的积液细胞学标本纳入研究。进行细胞离心涂片/涂片、细胞块切片及免疫组化研究，并与临床结果及随访数据进行关联分析。

结果

在研究的99例病例中，细胞离心涂片/涂片阳性诊断率为68.7%（68/99）。阴性及可疑诊断率分别为16.2%（16/99）和15.1%（15/99）。对于细胞块切片，相应比例分别为71.7%（71/99）、16.2%（16/99）和12.1%（12/99）。另一方面，结合免疫组化结果时，相应比例分别变为76.8%（76/99）、20.2%（20/99）和3.0%（3/99）。经临床病理相关性分析，阳性、阴性及可疑诊断的总体比例分别为77.8%（77/99）、17.2%（17/99）和5.0%（5/99）。细胞离心涂片/涂片与细胞块切片之间的差异无统计学意义（P>0.05）。然而，结合免疫组化结果或临床病理相关性时，可疑诊断率的差异具有统计学意义（P<0.05）。应用于细胞块切片的免疫组化研究假阴性率为1.0%（1/99）。