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目的:探讨经支气管针吸活检(EBUS-TBNA)细胞块检测对于诊断肺癌的临床价值和意义。方法:回顾性分析2012年1月至2015年5月在我院行EBUS-TBNA检查的173例患者,收集标本,并应用液基细胞学(TCT)及细胞蜡块免疫组化法进行检测,分析在单独应用和联合应用时的敏感性、特异性以及准确性。结果:TCT检测结果阳性率是71.1%(123/173),细胞蜡块检测阳性率是87.28%(151/173),差异有统计学意义(P<0.05);而TCT联合细胞蜡块检测诊断的阳性率则是99.42%(172/173),高于单用细胞蜡块检测阳性率,差异有统计学意义(P<0.05);173例患者最终有172例经病理学确诊为肺癌,TCT敏感性为71.5%、准确性为71.1%,显著低于细胞蜡块免疫组化检测的敏感性87.79%、准确性87.28%,联合诊断敏感性、准确性均为100.0%。结论:通过对EBUS-TBNA取得的细胞块进行蜡块和细胞学的检测,可以有效提高对肺癌的诊断,为肺癌患者及早诊断、治疗赢得了时机。
Objective: To investigate the clinical value and significance of bronchial needle aspiration biopsy (EBUS-TBNA) cell block test in the diagnosis of lung cancer. Methods: 173 patients who underwent EBUS-TBNA in our hospital from January 2012 to May 2015 were retrospectively analyzed. The specimens were collected and detected by liquid-based cytology (TCT) and immunohistochemistry using paraffin block. Analyze the sensitivity, specificity, and accuracy when used alone and in combination. Results: The positive rate of TCT test was 71.1% (123/173), the positive rate of cell wax test was 87.28% (151/173), the difference was statistically significant (P <0.05) The positive rate was 99.42% (172/173), which was higher than the detection rate of single cell wax block (P <0.05). The final result of 173 patients was pathological diagnosis of lung cancer, TCT Sensitivity was 71.5%, accuracy was 71.1%, which was significantly lower than the sensitivity and accuracy of 87.79% and 87.28% of immunohistochemical detection of cell wax block. The sensitivity and accuracy of combined diagnosis were 100.0%. Conclusion: The detection of paraffin blocks and cytology of the cell mass obtained by EBUS-TBNA can effectively improve the diagnosis of lung cancer and has won the opportunity for early diagnosis and treatment of lung cancer.