液基细胞学检测在肺癌支气管刷片诊断中的应用价值

摘要

目的：探讨纤维支气管镜刷片（bronchofiberscopic (BFS) washing cytology，BWC）液基细胞学检测（Liquid-based Cytology test，LCT）在肺癌诊断中的价值。方法：收集同时进行LCT和传统涂片检查的纤支镜刷片的病例543例，分析LCT和传统涂片对肺癌诊断的敏感度，特异性和分型的准确性。结果：LCT和传统涂片法诊断肺癌的敏感度分别为87.2%和81.8%，差异有统计学意义（P＜0.05）。特异性分别为91.2%和94.8%，差异无统计学意义（P＞0.05）。细胞学分型诊断与组织学的符合率，在LCT中，鳞癌为94.4%,腺癌95.7%，小细胞癌90.9%，总符合率为93.4%。结论：LCT是在支气管刷检制片，染色等方面便于实施质量控制的一项新技术，在肺癌诊断中具有较高的敏感度和分型诊断符合率。%Objective: To explore the diagnostic value of Liquid-based cytology test ( LCT) for lung cancer in bronchoscopically biopsied specimens.Methods 543 cases of bronchoscopically biopsied specimens were identified for lung cancer with LCT as well as conventional smear test .The results were analyzed for the sensitivity,specificity and concordance with pathology in the two methods. Results The sensitivity of LCT and conventional smear for lung cancer identification were 87.2% and 81.8%,respectively,the difference was significant (P <0.05), whereas the specificity were 91.2%and 94.8%,respectively.Analysis for the concordance between cytology and pathology in 289 specimens revealed that the identity rate of LCT was 94.4%in squamous carcinoma,95.7%in adenocarcinoma and 90.9%in small cell carcinoma. Conclusion LCT was an effective and practicable method for the identification of lung cancer with higher sensitivity and specificity comparable with conventional smear test.