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目的探讨常规涂片联合瘤包石蜡切片辅以免疫组织化学技术在胸水细胞学病理诊断中的应用。方法收集2015年1月至2016年5月收检的胸水标本416例,以常规涂片189例为对照组(其中有活检组织学病理结果者68例),以常规涂片联合瘤包石蜡切片227例为观察组(其中有活检组织学病理结果者91例),辅以免疫组化技术的应用。基于组织病理学活检结果的比较,统计分析两组的阳性检出率、诊断准确率及胸水细胞学病理诊断的具体分型。结果两组胸水细胞学结果显示,对照组阳性检出率18.5%(35/189),观察组为34.8%(79/227),观察组阳性率明显高于对照组(P<0.01)。基于组织学病理活检结果分析两组的诊断准确率,对照组诊断准确率为80.9%(55/68),观察组为95.6%(87/91),观察组明显高于对照组(P<0.01)。诊断分型中以腺癌为主,占87.3%(69/79)。结论常规涂片联合瘤包石蜡切片在胸水细胞学病理诊断中可有效提高阳性检出率和准确率;辅以运用免疫组化技术可为临床对疾病的诊断、分型及个体化的精准靶向治疗提供可靠依据。
Objective To investigate the application of routine smear and tumor paraffin sections combined with immunohistochemistry in the diagnosis of pleural fluid cytology. Methods 416 cases of pleural effusion collected from January 2015 to May 2016 were collected, and 189 cases of routine smear were selected as the control group (including 68 cases of biopsy histopathological results). The routine smear combined with tumor paraffin section 227 cases of observation group (including biopsy histopathology results in 91 cases), supplemented by immunohistochemistry. Based on the histopathological biopsy results, the positive rate of the two groups was statistically analyzed, the diagnostic accuracy and specific classification of pleural fluid cytology pathological diagnosis. Results The results of pleural effusion in both groups showed that the positive rate was 18.5% (35/189) in the control group and 34.8% (79/227) in the observation group. The positive rate in the observation group was significantly higher than that in the control group (P <0.01). The diagnostic accuracy rate of the two groups was 80.9% (55/68) based on histopathological biopsy results. The observation group was 95.6% (87/91), and the observation group was significantly higher than the control group (P <0.01) ). Adenocarcinoma was the main type in diagnosis, accounting for 87.3% (69/79). Conclusion Conventional smear combined with tumor paraffin sections in pleural fluid cytology pathological diagnosis can effectively improve the positive detection rate and accuracy; combined with the use of immunohistochemistry for clinical diagnosis of disease, classification and individualized precision target To provide a reliable basis for treatment.