在经支气管超声引导下经支气管针吸活检中使用所谓的组织胶凝块法提高细胞块制备的细胞数量。
Improvement of cellularity on cell block preparations using the so-called tissue coagulum clot method during endobronchial ultrasound-guided transbronchial fine-needle aspiration.
机构信息
Department of Pulmonary and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore 21224, Maryland.
出版信息
Cancer Cytopathol. 2012 Jun 25;120(3):185-95. doi: 10.1002/cncy.20199. Epub 2011 Dec 5.
BACKGROUND
Cell block (CB) preparation during the endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) procedure plays an important role in the diagnosis of lung cancer and recovery of cellular material for molecular characterization of the tumor. However, the efficiency of the conventional method of CB preparation is suboptimal.
METHODS
In the current study, the "tissue coagulum clot" cell block (TCC-CB) method was used to prepare the CBs and its efficiency was compared with that of the conventional saline rinse cell block (NR-CB) method. A total of 84 consecutive TCC-CBs (106 lymph nodes [LNs] and 14 lung lesions) and 28 consecutive cases of NR-CB (39 LNs and 3 lung lesions) obtained within the same time period were included in the current study.
RESULTS
In the TCC-CB specimens, 94 of 106 LN cases (88.7%) yielded sufficient diagnostic material, as did 11 of 14 lung lesions (78.6%). In the NR-CB group, which was used as the control, 22 of 39 LN specimens (56.4%) and none of 3 lung specimens (0%) were found to provide sufficient diagnostic material. Although the average size of the LNs in the study group were not significantly different from those in the control group (1.76 cm vs 1.82 cm; P > .05), the overall nondiagnostic rates in the TCC-CB and NR-CB groups were 11.2% and 43.6%, respectively (P < .001). The nondiagnostic rates of the lung specimens were 15.4% in the TCC-CB group and 100% in the NR-CB group (P < .05). In addition, immunohistochemistry studies and epidermal growth factor receptor (EGFR)/KRAS mutational analyses were performed in 26 and 14 TCC-CB cases, respectively. With the exception of 1 case, all of them had satisfactory results.
CONCLUSIONS
The data from the current study demonstrate that the TCC-CB method significantly increases the cellular yield of CB preparations without compromising cytomorphological characterization of tumor cells.
背景
经支气管超声引导针吸活检（EBUS-TBNA）过程中的细胞块（CB）制备对于肺癌的诊断和肿瘤细胞的分子特征恢复具有重要作用。然而，传统的 CB 制备方法的效率并不理想。
方法
在本研究中，使用了“组织凝块细胞块（TCC-CB）”方法来制备 CB，并将其与常规的生理盐水冲洗细胞块（NR-CB）方法的效率进行了比较。共纳入了同期 84 例连续的 TCC-CB（106 个淋巴结[LN]和 14 个肺病变）和 28 例连续的 NR-CB（39 个 LN 和 3 个肺病变）。
结果
在 TCC-CB 标本中，106 个 LN 病例中有 94 例（88.7%）获得了足够的诊断材料，14 个肺病变中有 11 例（78.6%）获得了足够的诊断材料。在 NR-CB 组中，作为对照组，39 个 LN 标本中有 22 个（56.4%）和 3 个肺标本中没有一个（0%）提供了足够的诊断材料。尽管研究组中 LN 的平均大小与对照组无显著差异（1.76cm 比 1.82cm；P＞0.05），但 TCC-CB 和 NR-CB 组的总体非诊断率分别为 11.2%和 43.6%（P＜0.001）。TCC-CB 组的肺标本非诊断率为 15.4%，NR-CB 组为 100%（P＜0.05）。此外，在 26 例 TCC-CB 病例中进行了免疫组织化学研究，在 14 例 TCC-CB 病例中进行了表皮生长因子受体（EGFR）/KRAS 突变分析。除 1 例外，所有病例均取得了满意的结果。
结论
本研究的数据表明，TCC-CB 方法显著提高了 CB 制备的细胞产量，同时不影响肿瘤细胞的细胞形态学特征。
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