恶性脑膜炎：脑脊液细胞学检查的合理方法
Malignant meningitis: a rational approach to cerebrospinal fluid cytology.
作者信息
MacKenzie J M
机构信息
Department of Pathology, Aberdeen Royal Infirmary.
出版信息
J Clin Pathol. 1996 Jun;49(6):497-9. doi: 10.1136/jcp.49.6.497.
AIM
To clarify laboratory guidelines for cerebrospinal fluid (CSF) cytology.
METHODS
Clinical and pathological data relating to 54 patients with cytologically malignant cells in the CSF were reviewed, together with CSF cell counts and protein measurements for 29 patients. Utilising this data, criteria were established for CSF cytology and validated by review of 100 patients in whom CSF cytology had not been carried out on the basis of these criteria.
RESULTS
There was only one false positive diagnosis of malignancy on the basis of CSF cytology. All patients with malignant cells in the CSF fulfilled at least one of the following criteria: clinically known or suspected malignancy; raised cell count; raised protein concentration. In none of the 100 patients, in whom cytology was not performed, was the diagnosis of malignant meningitis missed.
CONCLUSION
Cytology should be performed on CSF specimens from all patients with known, or suspected, malignancy, but in other cases, only if the cell count or protein concentration, or both, is raised.
目的
阐明脑脊液（CSF）细胞学的实验室指南。
方法
回顾了54例脑脊液中存在细胞学恶性细胞患者的临床和病理数据，以及29例患者的脑脊液细胞计数和蛋白质测量结果。利用这些数据，制定了脑脊液细胞学标准，并通过对100例未根据这些标准进行脑脊液细胞学检查的患者进行回顾来验证。
结果
基于脑脊液细胞学仅有1例假阳性恶性诊断。所有脑脊液中有恶性细胞的患者至少符合以下标准之一：临床已知或怀疑为恶性肿瘤；细胞计数升高；蛋白质浓度升高。在未进行细胞学检查的100例患者中，无一例漏诊恶性脑膜炎。
结论
对于所有已知或疑似恶性肿瘤的患者，均应进行脑脊液标本的细胞学检查，但在其他情况下，仅当细胞计数或蛋白质浓度或两者均升高时才进行。
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