细胞块石蜡包埋切片在良恶性胸腹腔积液鉴别诊断中的应用价值

摘要

目的 探求细胞块石蜡包埋切片诊断良恶性胸腹腔积液的价值.方法 随机选取本院2015年11月至2017年12月收治的疑似恶性胸腹腔积液患者105例,采集所有患者胸腹腔积液标本,分别行细胞块石蜡包埋切片、细胞涂片及细胞脱落病理学检查,并以细胞脱落病理学检查结果为金标准,评估细胞块石蜡包埋切片、细胞涂片诊断恶性胸腹腔积液阳性率,并比较两种方式的诊断价值.结果 本组50份胸腔积液标本中,经细胞脱落病理学检查结果显示,有36份为恶性胸腔积液;55份腹腔积液标本中,经细胞脱落病理学检查结果显示,有42份为恶性腹腔积液;细胞块石蜡包埋切片诊断胸腔积液阳性检出率高于细胞涂片(80.56％比58.33％),差异有统计学意义(P＜0.05);细胞块石蜡包埋切片诊断腹腔积液阳性检出率高于细胞涂片(85.71％比64.29％),差异有统计学意义(P＜0.05);细胞块石蜡包埋切片诊断恶性胸腔积液和恶性腹腔积液的灵敏度、特异度、准确度均高于细胞涂片,差异有统计学意义(均P＜ 0.05).结论 细胞块石蜡包埋切片在鉴别良、恶性胸腹腔积液中具有较高的灵敏度、特异度,可提升恶性胸腹腔积液诊断准确率,为临床诊治该病提供重要依据.%Objective To investigate the value of paraffin-embedded section of cell block in the diagnosis of benign or malignant pleural and peritoneal effusion.Methods 105 patients suspected with malignant pleural and peritoneal effusion admitted into tour hospital from November,2015 to December,2017 were selected as the research objects.The specimens of pleural and peritoneal effusion of all the patients were collected.And these specimens were given paraffin-embedded section of cell block,cell smear,and exfoliative cell pathological examination.The results of exfoliative cell pathological examination were taken as the gold standard.The positive rates of malignant pleural and peritoneal effusion diagnosed by paraffin-embedded section of cell block and cell smear were evaluated.The diagnostic value of the two methods was compared.Results Among the 50 pleural effusion specimens,the results of exfoliative cell pathological examination showed that there were 36 cases of malignant pleural effusion.Among the 55 peritoneal effusion specimens,the results of exfoliative cell pathological examination showed that there were 42 cases of malignant peritoneal effusion.The positive detection rate of pleural effusion diagnosed by paraffin-embedded section of cell block (80.56％) was higher than that diagnosed by cell smear (58.33％),with a statistical difference (P ＜ 0.05).The positive detection rate of peritoneal effusion diagnosed by paraffin-embedded section of cell block (85.71％) was higher than that diagnosed by cell smear (64.29％),with a statistical difference (P ＜ 0.05).The sensitivity,specificity,and accuracy of paraffin-embedded section of cell block in the diagnosis of malignant pleural and peritoneal effusion were higher than those of cell smear,with statistical differences (all P ＜ 0.05).Conclusions Paraffin-embedded section of cell block in the differential diagnosis of benign or malignant pleural and peritoneal effusion has high sensitivity and specificity,and can increase the diagnostic accuracy and provide an important basis for clinical diagnosis and treatment of the disease.