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目的：探讨浆膜腔积液诊断细胞学超微结构研究与临床应用价值。方法：对浆膜腔积液２５０例进行光镜与透射电镜对比研究。结果：１７５例超微结构观察评价细胞学论断是满意标本，比文献报道稍高。本研究根据细胞排列、连接，微绒毛、细胞器、胞浆中分泌颗粒、微丝和核等超微结构的形态特征能够鉴别浆膜积液原发性间皮瘤细胞和转移性恶性细胞，帮助胸水中肺癌详细分型并对腹水中卵巢囊腺癌准确鉴别浆液性或粘液性的组织类型。浆膜积液约３０％以上仅有积液体征，因而透射电镜对探讨原发灶比光镜更准确。结论：积液中很多病例难以获取病理学证实，则电镜是浆膜腔积液诊断细胞学重要的辅助诊断方法，具有临床应用价值。
Objective: To study the ultrastructural and clinical value of diagnostic cytology for serous effusion. Methods: A comparative study of light and transmission electron microscopy was performed on 250 cases of effusion. RESULTS: A total of 175 ultrastructure observations and evaluations of cytological findings were satisfactory samples, which were slightly higher than those reported in the literature. In this study, according to the morphological characteristics of ultrastructure such as cell arrangement, junction, microvilli, organelles, secretory granules in cytoplasm, microfilaments, and nucleus, it is possible to identify serous effusion primary mesothelioma cells and metastatic malignant cells. Detailed classification of lung cancer in pleural fluid and accurate identification of serous or mucinous tissue types for ovarian cystadenocarcinoma in ascites. More than 30% of the effusion of the serosal fluid has only a sign of fluid accumulation. Therefore, the TEM is more accurate than the light microscope in the study of primary lesions. Conclusion: It is difficult to obtain pathological confirmation in many cases of effusion. Electron microscopy is an important diagnostic method for the diagnosis of serous effusions. It has clinical application value.