Liu Yan, Xu Mei-lin, Wang Jing, Wu Bing-quan, Zhong Hao-hao, Fang Wei-gang
Department of Pathology, Tianjin Chest Hospital, Tianjin 300051, China.
Zhonghua Bing Li Xue Za Zhi. 2012 Mar;41(3):181-5. doi: 10.3760/cma.j.issn.0529-5807.2012.03.008.
To evaluate the application of traditional cytomorphology, telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis of pleural effusion and bronchoalveolar lavage samples.
A total of 123 agar-paraffin double-embedded pleural effusion and bronchoalveolar lavage fluid samples were enrolled into study. The cytomorphologic features were reviewed and correlated with immunocytochemical findings and telomerase activity.
Telomerase activity was detected in 53 specimens using the real-time telomeric repeat amplification protocol. Amongst the cases studied, 39 samples (31.7%) contained overtly malignant cells while 20 cases (16.0%) were equivocal by conventional cytology. After verification by immunocytochemistry and clinical follow-up data, the diagnostic accuracy of telomerase activity and cytology was 87.0% and 82.1%, respectively. The sensitivity (97.6%) and specificity (100.0%) of cytology examination, when combined with telomerase activity analysis, were greater than those of cytology examination or telomerase activity analysis alone.
Telomerase activity analysis can be used as an adjunctive investigative tool in cytology assessment of pleural effusion and bronchoalveolar lavage samples. The diagnostic accuracy can be further improved with the application of immunocytochemistry on agar-paraffin double-embedded cell block tissues.
评估传统细胞形态学、端粒酶活性分析及免疫细胞化学在胸腔积液和支气管肺泡灌洗样本细胞病理学诊断中的应用。
共纳入123例经琼脂-石蜡双重包埋的胸腔积液和支气管肺泡灌洗液体样本进行研究。回顾细胞形态学特征，并与免疫细胞化学结果及端粒酶活性进行关联分析。
采用实时端粒重复序列扩增法在53个标本中检测到端粒酶活性。在所研究的病例中，39个样本（31.7%）含有明显的恶性细胞，而20例（16.0%）经传统细胞学检查结果不明确。经免疫细胞化学验证及临床随访数据分析，端粒酶活性检测和细胞学检查的诊断准确率分别为87.0%和82.1%。细胞学检查与端粒酶活性分析联合应用时的敏感性（97.6%）和特异性（100.0%）均高于单独的细胞学检查或端粒酶活性分析。
端粒酶活性分析可作为胸腔积液和支气管肺泡灌洗样本细胞学评估的辅助研究工具。在琼脂-石蜡双重包埋的细胞块组织上应用免疫细胞化学可进一步提高诊断准确率。
