论文部分内容阅读
目的探讨结核性淋巴腺炎针吸细胞病理学诊断与结核抗体相互关系的研究,提高淋巴结核诊断准确率。方法根据淋巴结核针吸细胞病理学诊断不同时期细胞学特点及特征结构改变,结合结核抗体检测做出分型诊断。结果在445例结核性淋巴腺炎中,结核初期—炎性增殖期1例占0.2%;结核早期—淋巴结节期82例占18.4%;结核中期—结核发性结节期有174例,占39.1%;结核晚期—干酪脓样坏死期有61例占13.7%;结核恢复期—纤维间质增殖期6例占1.3%。同时存在结核初期—炎性增殖期与结核早期—淋巴结节期有2例,占0.5%;结核早期—淋巴结节期与结核中期—结核性结节期有107例,占24.0%;结核中期—结核性结节期与结核晚期—干酷样脓样坏死期12例,占2.7%。期中进行结核抗体实验的有195例,ICT法共142例,阳性75例,占52.8%;DOT法160例,阳性100例,占62.5法;ELISA法共69例,阳性32例,占46.4%,炎性增殖反应期形态学变化,需要结合结核抗体阳性和腺苷脱氨本科明显增高更有助于诊断,结核结节期主要可有较多类上皮样细胞及郎罕氏细胞;而干酷样脓样坏死,主要见大量坏死组织及碎屑、少数残碎不全上皮样细胞,此期主要能查到抗酸菌为特点;纤维增殖期,抽出物难取,仅见少数纤维组织、纤维细胞和粘液间质为其特征,提示结核恢复、疤痕形成所致。细胞病理学结核诊断符合率明显高于传统诊断方法,高达98.4%。结论应用淋巴结针吸细胞病理学分型诊断与结核抗体相结合方法,为淋巴结核早期诊断、早期发现、早期治疗提供重要方法。
Objective To investigate the relationship between needle aspiration cytopathology and tuberculosis antibodies in tuberculous lymphadenitis and to improve the diagnostic accuracy of lymph node tuberculosis. Methods According to lymphocytic needle aspiration cytology diagnosis of different periods of cytology characteristics and structural changes, combined with tuberculosis antibody detection to make a sub-type diagnosis. Results Among the 445 cases of tuberculous lymphadenitis, 1 case had an early stage of tuberculosis - inflammatory proliferative phase accounting for 0.2%, 82 cases of early stage tuberculosis - lymphatic node (18.4%), 174 medium stage tuberculous nodules 39.1%; late tuberculosis - cheese pus-like necrosis 61 cases accounted for 13.7%; tuberculosis recovery - interstitial fibrosis 6 cases accounted for 1.3%. There were two cases (0.5%) in early stage of tuberculosis-inflammatory proliferative phase and early stage of tuberculosis-lymphadenopathy, 107 cases (24.0%) in early stage of tuberculosis-lymphnodes and mid-stage tuberculosis-tuberculous nodules; middle stage of tuberculosis- Tuberculous nodules and tuberculosis - dry cool like pus-like necrosis in 12 cases, accounting for 2.7%. There were 195 cases of tuberculosis antibody test in the period, 142 cases were ICT method, 75 cases were positive, accounting for 52.8%; 160 cases were DOT, 100 cases were positive, accounting for 62.5%; 69 cases were ELISA, 32 cases were positive, accounting for 46.4% , Morphological changes of the inflammatory proliferative response phase, the need for combination of tuberculosis antibody positive and adenosine deacetylase undergraduate significantly increased more conducive to the diagnosis of tuberculous nodules can have more types of epithelial cells and Langerhans cells; and dry Like the kind of pus-like necrosis, mainly seen a large number of necrotic tissue and debris, a small number of incomplete epithelial-like cells, the main period can be found in acid-fast bacilli; fiber proliferation period, the extract difficult to take, only a few fibrous tissue, fiber Cells and mucus interstitial for its characteristics, suggesting tuberculosis recovery, scar formation. The coincidence rate of cytopathological diagnosis of tuberculosis was significantly higher than that of the traditional diagnostic method, up to 98.4%. Conclusion The method of lymph node aspiration cytospatial diagnosis and tuberculosis antibody combination method provides an important method for the early diagnosis, early detection and early treatment of lymph node tuberculosis.