胸水细胞学涂片及细胞块检查：对恶性胸腔积液的辅助诊断价值
Examination of cytological smears and cell blocks of pleural fluid: Complementary diagnostic value for malignant effusions.
作者信息
Porcel J M, Quirós M, Gatius S, Bielsa S
机构信息
Pleural Medicine Unit, Arnau de Vilanova University Hospital, Lleida, Spain.
Pleural Medicine Unit, Arnau de Vilanova University Hospital, Lleida, Spain.
出版信息
Rev Clin Esp (Barc). 2017 Apr;217(3):144-148. doi: 10.1016/j.rce.2016.11.004. Epub 2016 Dec 28.
OBJECTIVES
To evaluate the independent usefulness of pleural fluid smear and cell block (CB) preparations for the diagnosis of malignant effusions.
PATIENTS AND METHODS
A total of 632 cytological smears and 554 CBs from 414 consecutive patients with malignant effusions were retrospectively evaluated.
RESULTS
The diagnostic yield of a first specimen was 44% regardless of whether a smear or CB cytologic examination was performed. The use of subsequent separated specimens increased the identification of malignancy to 56%. Overall, 11% of samples found to be negative by cytologic smears showed malignant cells on CBs, whereas 15% of negative CBs were reported as positive on smear slides. Pleural fluid specimens with low red and/or white blood cell counts more frequently resulted in the generation of suboptimal CB preparations.
CONCLUSIONS
If CBs and smears are prepared and examined, the percentage of positive diagnoses will be greater than if only one method is used.
目的
评估胸水涂片和细胞块（CB）制备在恶性胸腔积液诊断中的独立应用价值。
患者和方法
回顾性评估了414例连续恶性胸腔积液患者的632份细胞学涂片和554份细胞块。
结果
无论进行涂片还是细胞块细胞学检查，首次标本的诊断阳性率均为44%。使用后续单独的标本可将恶性肿瘤的识别率提高到56%。总体而言，11%的细胞学涂片阴性样本在细胞块中显示有恶性细胞，而15%的细胞块阴性样本在涂片上报告为阳性。红细胞和/或白细胞计数低的胸水标本更常导致细胞块制备效果不佳。
结论
如果同时制备并检查细胞块和涂片，阳性诊断的百分比将高于仅使用一种方法时。
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