通过导管抽吸获得的样本进行液基细胞学检测适用于肺部恶性肿瘤的支气管镜确诊。
Liquid-based cytological test of samples obtained by catheter aspiration is applicable for the bronchoscopic confirmation of pulmonary malignant tumors.
作者信息
Li Dai-Rong, Wan Tao, Su Yi, Ding Min, Wu Jin-Xing, Zhao Yong
机构信息
Department of Respiratory Medicine, The First Affiliated Hospital of Chongqing Medical University Chongqing, P. R. China.
出版信息
Int J Clin Exp Pathol. 2014 Apr 15;7(5):2508-17. eCollection 2014.
The aim of the present study is to confirm the value of electronic bronchoscopy-aided catheter aspiration technique with liquid-based cytological test in the diagnosis of bronchogenic carcinoma. A total of 815 patients of lung cancer were evaluated by bronchoscopy between February 2011 and June 2012. Catheter aspiration technique and forceps biopsy during bronchoscopy were employed to obtain adequate tissue specimens. Liquid-based cytological test and conventional smears for catheter aspiration were used for cytological detection of the tumors. For all cytological specimens, slide preparations with LCT and CS were reviewed by two senior pathologists, who were blinded to patient medical history. Complications related to electronic bronchoscopy, such as bleeding, were clinically judged as light, moderate or severe by the needs for clinical interventions. The diagnostic yield of catheter aspiration in endobronchial visible lesions (tumor, infiltrative and necrotic lesions) was 94.6% (success rates concerning malignancy), which was slightly higher than that of the forceps biopsy (91.4%, P<0.05). The diagnostic yield of catheter aspiration in endobronchial invisible lesions (normal, compressive and nonspecific lesions) was 82.8%, which was significantly higher than that of the forceps biopsy (51.4%, P<0.01). The combination of the forceps biopsy with the cytological analysis of the catheter aspiration increased the diagnostic sensitivity in both lesion types (P<0.05). For catheter aspiration, the positive rate of lung cancer by liquid-based cytological test was superior to that by conventional smears (P<0.05). The catheter aspiration is a sampling technique that produces higher diagnostic rate for lung cancers compared with forceps biopsy. Liquid-based cytological test is routinely applicable for the diagnosis of lung cancer using samples collected through electronic bronchoscopy.
本研究旨在证实电子支气管镜辅助导管抽吸技术联合液基细胞学检查在支气管肺癌诊断中的价值。2011年2月至2012年6月期间，共有815例肺癌患者接受了支气管镜检查评估。在支气管镜检查过程中采用导管抽吸技术和钳取活检以获取足够的组织标本。采用液基细胞学检查和导管抽吸的传统涂片进行肿瘤的细胞学检测。对于所有细胞学标本，由两位资深病理学家对采用液基薄层制片（LCT）和传统涂片（CS）制备的玻片进行阅片，他们对患者病史不知情。与电子支气管镜相关的并发症，如出血，根据临床干预的需求在临床上判断为轻度、中度或重度。导管抽吸在支气管内可见病变（肿瘤、浸润性和坏死性病变）中的诊断率为94.6%（恶性肿瘤成功率），略高于钳取活检（91.4%，P<0.05）。导管抽吸在支气管内不可见病变（正常、压迫性和非特异性病变）中的诊断率为82.8%，显著高于钳取活检（51.4%，P<0.01）。钳取活检与导管抽吸的细胞学分析相结合提高了两种病变类型的诊断敏感性（P<0.05）。对于导管抽吸，液基细胞学检查的肺癌阳性率优于传统涂片（P<0.05）。与钳取活检相比，导管抽吸是一种对肺癌诊断率更高的采样技术。液基细胞学检查常规适用于使用通过电子支气管镜采集的样本诊断肺癌。
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