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目的通过液基制片(LBP)方法在非妇科脱落细胞学胸腹水领域中的应用,探讨液基细胞学制片方法在非妇科脱落细胞领域制片的优缺点及其应用前景。方法对本院25例胸腹水,应用液基制片,并同步与传统涂片进行了细胞形态学观察,免疫组化染色和荧光原位杂交(FISH)检测,并应用图像分析系统加以定量对比分析。结果定性观察发现,液基制片的细胞明显比传统涂片的细胞变小,细胞形态也发生了一定的变化;免疫组化LCA、EMA、Vim和PCNA染色与传统涂片染色未见明显不同,FISH检测结果,除酶消化时间较传统涂片延长5 min外,其他未见明显不同;细胞定量结果发现,液基制片的细胞面积比传统制片的细胞面积减少了58.1%(P<0.01),细胞周长减少了42.7%(P<0.01),细胞等效直径缩短了37.5%(P<0.01),细胞长径缩短了37.4%(P<0.01),细胞短径也缩短了37.8%,细胞长短径之比未见明显差异(P>0.05)。液基制片的细胞形状因子减小了18.12%(P<0.01),细胞圆形度增加了13.7%(P<0.01),细胞平均光度增加了57.1%(P<0.01),细胞积分光度减少了41.5%(P<0.01),细胞平均灰度未见明显差异(P>0.05)。结论液基细胞学制片明显缩小了目标细胞,其形态也发生了较明显改变,但不影响测试细胞进一步的免疫组化染色和FISH检测,在非妇科脱落细胞学领域的应用,对诊断医师具有较高适应训练要求,也仍具有进一步改进的空间。
OBJECTIVE: To investigate the advantages and disadvantages of liquid-based cytology in the field of non-gynecological exfoliative cells and its application prospects by liquid-based imaging (LBP) in non-gynecological exfoliative cytology ascites and pleural effusion. Methods 25 cases of hydrothorax and ascites in our hospital were treated with liquid-based tablet preparation. The morphological observation, immunohistochemical staining and FISH were carried out synchronously with traditional smears, and the results were compared quantitatively with image analysis system analysis. Results The results of qualitative observation showed that the number of cells in liquid-based tablets was significantly smaller than that in conventional smears and the morphology of cells was also changed. The immunohistochemical staining of LCA, EMA, Vim and PCNA showed no significant difference with traditional smears The results of FISH showed that there was no significant difference except for the enzymatic digestion time which was prolonged 5 min compared with the conventional smear. The quantitative results of the cells showed that the cell area of the liquid-based preparation was reduced by 58.1% compared with the traditional preparation (P < 0.01). The cell perimeter was reduced by 42.7% (P <0.01), the cell equivalent diameter was shortened by 37.5% (P <0.01), the cell diameter was shortened by 37.4% (P <0.01) %, The ratio of cell length to diameter had no significant difference (P> 0.05). The cell shape factor decreased by 18.12% (P <0.01), the cell circularity increased by 13.7% (P <0.01), the average cell luminosity increased by 57.1% (P <0.01) 41.5% (P <0.01), no significant difference in average cell gray level (P> 0.05). Conclusion liquid-based cytology significantly reduced the target cells, its morphology has changed significantly, but does not affect the test cells further immunohistochemical staining and FISH detection, non-gynecological exfoliative cytology in the field of diagnosis of physicians With higher adaptation training requirements, there is still room for further improvement.