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[目的]探讨膜式超薄液基细胞学检测技术(ThinPrep cytology test,TCT)在肺癌诊断中的应用价值。[方法]对591例(肺癌323例,非肺癌268例)支气管肺泡灌洗液(bronchoalveo-lar lavage fluid,BALF)或纤维支气管镜刷片标本同时进行TCT和直接涂片法检测,比较两种方法的敏感度、特异性、阳性预测值和准确率。[结果]TCT检测的敏感度为36.5%,特异性为99.6%,阳性预测值为99.2%,准确率为65.1%。直接涂片法检测敏感度为13.6%,特异性为100%,阳性预测值为100.0%,准确率为52.8%。TCT检测的敏感度、准确率均高于直接涂片法(χ2=72.014,P=0.000;χ2=4.817,P=0.028)。无论纤支镜下可见肿瘤征象或未见肿瘤征象,BALF的TCT检测敏感度与纤维支气管镜刷片的TCT检测敏感度比较,差异均无统计学意义(χ2=3.548,P=0.06;χ2=0.031,P=0.859)。[结论]TCT检测可提高肺癌诊断率,BALF的TCT检测可推广应用于临床。
[Objective] To explore the value of ThinPrep cytology test (TCT) in the diagnosis of lung cancer. [Method] The specimens of bronchiolveo-lar lavage fluid (BALF) or bronchofibroscopy were detected in 591 cases (323 cases of lung cancer and 268 cases of non-lung cancer) by TCT and direct smear method. Sensitivity, specificity, positive predictive value and accuracy of the method. [Results] The sensitivity of TCT was 36.5%, the specificity was 99.6%, the positive predictive value was 99.2% and the accuracy was 65.1%. Direct smear detection sensitivity was 13.6%, specificity was 100%, the positive predictive value was 100.0%, the accuracy rate was 52.8%. The sensitivity and accuracy of TCT were higher than that of direct smear (χ2 = 72.014, P = 0.000; χ2 = 4.817, P = 0.028). There was no significant difference between the TCT detection sensitivity of BALF and the TCT detection sensitivity of the bronchoscopic brush disc (χ2 = 3.548, P = 0.06; χ2 = 0.031, P = 0.859). [Conclusion] The detection of TCT can improve the diagnostic rate of lung cancer. The TCT of BALF can be widely used in clinic.