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目的评价印片细胞学在乳腺癌前哨淋巴结活检术中的病理诊断价值。方法选择105例早期乳腺癌患者行前哨淋巴结活检,其中成功101例。沿前哨淋巴结长轴每隔2～3 mm剖开,每个剖面均进行印片细胞学检查,印片使用HE染色,印片后的淋巴结分别送石蜡切片,将印片结果与石蜡的HE染色结果进行比对比较。结果105例患者前哨淋巴结活检的检出率为96.2%(101/ 105),101例患者中共检出202枚前哨淋巴结。在常规石蜡切片作为诊断标准时,前哨淋巴结术中印片细胞学的敏感性、特异性、准确性、阳性及阴性预测值分别为92.1%、98.8%、97.5%、94.6%和98.2%,101例患者的印片敏感性、特异性、准确性、阳性及阴性预测值分别为89.3%、98.6%、96.0%、96.2%和96.0%。将术中印片结果与进一步的连续切片结果进行比对,前哨淋巴结印片的敏感性、特异性、准确性、阳性及阴性预测值分别为83.3%、98.8%、95.5%、94.6%和95.8%,101例患者的印片敏感性、特异性、准确性、阳性及阴性预测值分别为81.3%、100.0%、94.1%、100.0%和92.0%。结论印片细胞学对乳腺癌前哨淋巴结术中病理诊断有较高的价值,可以准确提供术中诊断信息,与石蜡切片有很高的一致性。
Objective To evaluate the diagnostic value of printing cytology in sentinel lymph node biopsy of breast cancer. Methods 105 cases of early breast cancer patients underwent sentinel lymph node biopsy, of which 101 cases were successful. Along the long axis of the sentinel lymph node cut every 2 ~ 3 mm, each section were printed cytology, printed with HE staining, after printing the lymph nodes were sent to paraffin sections, the results of the printing and paraffin HE staining The results were compared. Results The detection rate of sentinel lymph node biopsy in 105 patients was 96.2% (101/105). Of the 101 patients, 202 sentinel lymph nodes were detected. Sensitivity, specificity, accuracy, positive and negative predictive value of smear cytology in sentinel lymph node biopsy were 92.1%, 98.8%, 97.5%, 94.6% and 98.2% respectively in routine paraffin sections as diagnostic criteria, and 101 The sensitivity, specificity, accuracy, positive and negative predictive value of the print on the patient were 89.3%, 98.6%, 96.0%, 96.2% and 96.0%, respectively. The sensitivity, specificity, accuracy, positive and negative predictive value of sentinel lymph node print were 83.3%, 98.8%, 95.5%, 94.6% and 95.8, respectively, compared with the results of further serial sections %. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the imprint of the 101 patients were 81.3%, 100.0%, 94.1%, 100.0% and 92.0%, respectively. Conclusion Printed cytology has high value in intraoperative and pathological diagnosis of sentinel lymph node in breast cancer, which can accurately provide intraoperative diagnosis information and have high consistency with paraffin section.