Rabinovitch A, Cornbleet P J
College of American Pathologists, Northfield, Ill.
Arch Pathol Lab Med. 1994 Jan;118(1):13-7.
Questionnaires addressing laboratory practices in cerebrospinal fluid and body fluid (serous, synovial) microscopy were distributed to participants in the Clinical Microscopy Survey of the College of American Pathologists, Northfield, Ill, in 1985 and 1989. In both Surveys, cell enumeration was performed primarily by hemocytometry, while nearly all respondents used Wright-stained microscopy. There was little formal quality control to assess the accuracy of counts or differential cell count. Less than 55% of laboratories used the cytocentrifuge. About half of respondents performed a differential cell count on every sample. Slides with atypical or malignant cells were usually (> 85%) reviewed by physicians without automatic referral to the cytopathology section. Only about half of respondents examined every synovial fluid specimen with polarized microscopy for crystals. Other than a modest increase in use of the cytocentrifuge, the 1989 Survey showed little interval change in practices. In 1989, there was equal dependence on Wright's and Papanicolaou's stains for an infrequent diagnosis of malignancy. The low rate of positives may have related to the high prevalence of wedge smears, a suboptimal technique. The Hematology and Clinical Microscopy Resource Committee of the College of American Pathologists makes recommendations for optimal laboratory handling of body fluid specimens for microscopy.
1985年和1989年，针对脑脊液及体液（浆液性、滑膜液）显微镜检查实验室操作的调查问卷被分发给了伊利诺伊州诺斯菲尔德美国病理学家学会临床显微镜检查调查的参与者。在这两次调查中，细胞计数主要通过血细胞计数法进行，而几乎所有受访者都采用瑞氏染色显微镜检查。几乎没有正式的质量控制来评估计数或细胞分类计数的准确性。不到55%的实验室使用细胞离心涂片仪。约一半的受访者对每个样本都进行细胞分类计数。带有非典型或恶性细胞的玻片通常（>85%）由医生进行检查，而不会自动转诊至细胞病理学部门。只有约一半的受访者对每个滑膜液标本使用偏振显微镜检查晶体。除了细胞离心涂片仪的使用略有增加外，1989年的调查显示操作方面几乎没有间隔变化。1989年，在罕见恶性肿瘤诊断中，对瑞氏染色和巴氏染色的依赖程度相同。阳性率较低可能与楔形涂片的高比例有关，楔形涂片是一种不太理想的技术。美国病理学家学会血液学和临床显微镜检查资源委员会对体液标本用于显微镜检查的最佳实验室处理提出了建议。
