摘要
目的探讨液基细胞病理检测（LCT）在非小细胞肺癌（NSCLC）纵隔淋巴结分期的应用价值。方法回顾性分析2011年8月~2013年12月间在宝鸡市中心医院96例行常规电子支气管镜检查经组织学确诊的并最终行手术切除的NSCLC病例,术前均行经支气管针吸活检（TBNA）对纵隔淋巴结分期,TBNA穿刺物分别行常规涂片（CS）法与LCT法处理,所有患者行肺癌根治切除术及淋巴结清扫术,分析LCT在NSCLC术前纵隔淋巴结分期中病理诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值,同时分析其分期的准确率。结果 96例患者经TBNA检查7个部位共258组淋巴结,TBNA穿刺成功519针（96.29%,519/539）。LCT法阳性的219组（84.88%,219/258）高于CS法阳性的141组（54.65%,141/258）,P〈0.01。LCT法与CS法的敏感性、特异性、准确性、阳性预测值和阴性预测值分别是96.05%、100%、96.51%、100%、76.92%,和61.84%、100%、66.28%、100%、25.64%。LCT法在NSCLC纵隔淋巴结分期的敏感性、阴性预测性、准确性等方面均明显高于CS法,P〈0.01。LCT法c-N分期准确率为93.75%,高于CS法的62.5%,P〈0.01。结论 LCT法有效提高NSCLC纵隔淋巴结分期诊断敏感性、准确性、c-N分期准确率,值得临床推广应用。
Objective To inve stigate the clinical value of liquid-based cytologic test（ LCT） in mediastinal staging non-small cell lung cancer（ NSCLC）. Methods The clinical data of 96 patients with NSCLC diagnosed by conventional electronic bronchoscopy from August 2011 to December 2013 in our hospital were retrospectively analyzed. Mediastinal staging by transbronchial needle aspiration（ TBNA） were performed before operation. TBNA specimens were prepared by conventional smears（ CS） and LCT smears respectively. All patients subsequently underwent pulmonary resection with mediastinal lymph node dissection. The differences in the cytopathological diagnosis between the two preparation methods in TBNA specimens were compared. The cytopathological diagnosis and histopathological diagnosis were also compared. Results 96 patients with 258 lymph nodes were punctured. TBNA procedures were successfully carried out in 519 /539（ 96. 29%）. The positive rate of TBNA specimens by LCT was 84. 88%（ 219 /258）,while the positive rate of TBNA specimens by CS was 54. 65%（ 141 /258）（ P〈0. 01）. Overall diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of cytopathology for mediastinal staging in TBNA specimens by LCT were 96. 05%,100%,96. 51%,100% and 76. 92%,while those by CS were 61. 84%,100%,66. 28%,100% and 25. 64%. The sensitivity,negative predictive value and accuracy of LCT smears were higher than those of CS（ P〈0. 01）. The overall accuracy of c-N staging by TBNA of LCT smears（ 93. 75%） was higher than that of CS（ 62. 5%）（ P〈0. 01）. Conclusion Cytopathology by LCT is sensitive and accurate in the mediastinal staging of NSCLC in TBNA specimens. The method of LCT can improve the accuracy of cN staging of NSCLC,which has certain clinical application value.
出处
《临床肺科杂志》
2015年第5期821-825,共5页
Journal of Clinical Pulmonary Medicine
关键词
经支气管针吸活检
支气管镜检查
液基细胞技术
肺癌
细胞病理学
transbronchial needle aspiration
bronchoscopy
liquid-based cytologic test
lung cancer
cytopathology
