简易细胞块制作和细胞涂片并用技术在淋巴结细针穿刺标本中的应用
| 作者: |
1,2李印,
3孙晓,
4何海生
1 南阳市中心医院病理科，河南 南阳 473000 2 南阳市中心医院肿瘤医院病理科，河南 南阳 473000 3 南阳市中心医院肿瘤内科，河南 南阳 473000 4 南阳市中心医院肿瘤医院肿瘤外科，河南 南阳 473000 |
| 通讯: |
李印
Email: liyin176882@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.06.003 |
摘要
目的：探讨一种简易细胞块制作和细胞涂片并用技术对淋巴结细针穿刺标本的应用价值。 方法：对用一次性注射器获取的淋巴结穿刺标本163例中的152例(93.3%)进行分段提取行针筒乳头部涂片细胞学、针栓内标本或针栓内标本合并针筒乳头部涂片残余标本简易制作细胞块、针头针芯部涂片细胞学。根据细胞量丰富程度、细胞形态保存完好与否，是否满足高质量诊断需要分为高等质量标本(high-quality specimen，HQS)、中等质量标本(medium-quality specimen，MQS)、低等质量标本(low-quality specimen，LQS)。比较三者分段提取的细胞标本的满意度及应用价值。结果：针筒乳头细胞涂片细胞形态观察比简易细胞块切片更清晰，获HQS涂片147例(96.7%)；细胞块切片可观察到微组织结构和细胞涂片两种形态，获HQS标本145例(95.4%)，与针筒乳头细胞涂片差异无统计学意义，但能和针筒乳头细胞涂片标本互相补充，利于免疫组织化学和分子病理学检测，肿瘤分型诊断更容易；针芯涂片细胞常挤压变形且细胞量少，仅获HQS涂片46例(30.3%)，与前两者差异有统计学意义(P<0.05)。结论：淋巴结细针穿刺标本可采用分段提取同时简易制作细胞块和针筒乳头标本为主的细胞涂片技术，对淋巴结疾病精准诊断具有较高应用价值。
关键词：
淋巴结；细针穿刺细胞学；细胞块
Application of combination a simple cell block preparation technology and cytology smear preparation in specimens obtained from fine needle aspiration of lymph nodes
CorrespondingAuthor: LI Yin Email: liyin176882@126.com
DOI: 10.3978/j.issn.2095-6959.2019.06.003
Abstract
Objective: To investigate the value of combination application of a simple cell block preparation technology and cytology smears in specimens of lymph nodes obtained from fine needle aspiration. Methods: The 152 cases of lymph nodes specimens aspirated by using a 5 mL disposable syringe with size 7 needle were divided into three parts: the specimens obtained from syringe nipple with cytology smears, the cell block preparation with cotton swab and needle assistant and using a self-clotting method obtained from needle hub gap or needle hub gap and syringe nipple residue materials, the cytology smear specimens expelled from the needle tip. According to the cellular morphology integrity and cell richness, adequate or inadequate materials, the specimens then were divided into three types: high-quality specimens (HQS), medium-quality specimens (MQS), low-quality specimens (LQS). Comparson the three parts of cell specimen satisfaction and application value in cytological diagnosis. Results: The cell morphology of smears specimens expelled from syringe nipple were much clear than the cell block specimens, HQS rate was 96.7% (147/152). Compared with the nipple smears, the cell block preparation showed both microhistological structure and cytological morphology, HQS rate was 95.4% (145/152), there was no statistically significance difference between them (P>0.05), but the cell block contained adequate material to perform immunocytochemistry and gene detection and classification diagnosis of tumors was much easier, the two methods were complementary for accurate diagnosis. Compared the two other specimens, the needle core specimens expelled from tip were less cellular and cytological morphology was often not clear, HQS rate was only 30.3% (46/152), there was a statistical significance (P<0.05). Conclusion: Using the method of segmentation collection the fine needle aspiration specimens of lymph nodes, and then combination the simple cell blocks preparation and cytological smears mainly from syringe nipple will have a high applied value in lymph nodes disease.
Keywords：
lymph nodes; fine needle aspiration; cell block