组织学与印片细胞学在胃肠道恶性肿瘤诊断中的相关性研究

A correlative study of histology and imprint cytology in the diagnosis of gastrointestinal tract malignancies.

作者信息

Sharma P, Misra V, Singh P A, Misra S P, Gupta S C

机构信息

Department of Pathology and Gastroenterology, M.L.N. Medical College, Allahabad.

出版信息

Indian J Pathol Microbiol. 1997 Apr;40(2):139-46.

PMID:9257499

Abstract

Endoscopic mucosal biopsies from 323 patients (201 from upper gastrointestinal tract and 122 from lower gastrointestinal tract) were studied to correlate the diagnostic efficacy of histology and imprint cytology in the diagnosis of malignant lesions of gastrointestinal tract. Of these 71 were from normal controls, 113 from benign lesions and 131 from malignant lesions. Histology showed no false positive reports but it was false negative in 6 cases (3 in oesophagus, 1 in stomach and 2 from colon). Imprint was false positive in 3 cases (2 oesophagus, 1 colon) and false negative in 2 cases (both oesophagus). The overall diagnostic accuracy of histology and imprint cytology in oesophagus, stomach and lower gastrointestinal tract was 95%, 98%, 98% and 95%, 100%, 98% respectively. When combined, the diagnostic accuracy increased to 98%, 100% and 100% in oesophagus, stomach and lower gastrointestinal tract respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy for histology and cytology irrespective of the site was 96%, 100%, 100%, 94%, 97% and 98.5%, 97%, 98%, 98%, 98% respectively. Thus imprint cytology can act as an adjunct to bioptic histology to increase the diagnostic efficacy and save the time but definitely it cannot replace it as chances of false positives are high.

摘要

对323例患者（201例来自上消化道，122例来自下消化道）的内镜黏膜活检进行研究，以关联组织学和印片细胞学在胃肠道恶性病变诊断中的诊断效能。其中71例来自正常对照，113例来自良性病变，131例来自恶性病变。组织学检查无假阳性报告，但有6例假阴性（食管3例，胃1例，结肠2例）。印片检查有3例假阳性（食管2例，结肠1例），2例假阴性（均为食管）。食管、胃和下消化道组织学和印片细胞学的总体诊断准确率分别为95%、98%、98%和95%、100%、98%。联合检查时，食管、胃和下消化道的诊断准确率分别提高到98%、100%和100%。无论部位如何，组织学和细胞学的敏感性、特异性、阳性预测值、阴性预测值和总体诊断准确率分别为96%、100%、100%、94%、97%和98.5%、97%、98%、98%、98%。因此，印片细胞学可作为活检组织学的辅助手段，以提高诊断效能并节省时间，但由于假阳性几率较高，它肯定不能取代活检组织学。