LBP制片技术在甲状腺结节细针穿刺 细胞学诊断中的应用

目的：探讨二代沉降式液基细胞学（liquid-based preparations，LBP）制片技术在甲状腺结节细针穿刺细胞学诊断中的应用价值。方法：267例甲状腺结节患者进行细针穿刺检查，分别采用LBP和传统涂片（coventional smear，CS）制片，比较两种方法制片的标本质量和细胞病理诊断结果。细胞学诊断结果按照甲状腺细胞病理学Bethesda报告系统进行分类。结果：LBP制片与CS比较，有效诊断细胞量增多，血细胞及炎症细胞更少，背景更干净，甲状腺滤泡上皮细胞形态与排列更清晰，三维立体感强，细胞重叠现象少。两种制片技术在细胞学诊断结果分类比较，差异有统计学意义（P<0.05)。LBP制片的标本满意率为84.27%，甲状腺乳头状癌阳性诊断率为3.74%，分别高于CS制片的75.28%和0.75%。结论：液基细胞学技术有利于提高甲状腺结节细针穿刺标本的质量及细胞学诊断的准确性，有助于鉴别甲状腺结节的良恶性，为甲状腺癌的早期诊断提供科学依据，具有较高的临床应用价值。

The application of LBP technique in the diagnosis of thyroid nodule fine needle puncture cytology

Objective: To explore the application value of the liquid based cytology (Liquid-based Preparations, LBP) production technology in the diagnosis of fine needle aspiration cytology of thyroid nodules. Methods: Fine needle aspiration was performed on 267 patients with thyroid nodules. LBP and CS (Coventional smear) were used to compare the quality of the specimens and the microscopic morphology. Cytological results were classified according to the thyroid cell pathology Bethesda reporting system. Results: Compared with CS, in LBP there were more cells for effective diagnosis, less blood and inflammatory cells, cleaner background, clearer morphology and arrangement of thyroid follicular epithelial cells, stronger 3 D stereo sense, less overlaps of cells. And the differences were statistically significant in the classification of cytological diagnosis between the two production techniques (P<0.05). The specimen satisfaction rate (84.27%) and the positive diagnosis rate of papillary thyroid carcinoma (3.74%) of LBP were higher than that of CS (75.28% and 0.75%). Conclusion: The application of LBP is beneficial to improve the quality of fine needle aspiration specimens of thyroid nodules and the accuracy of cytological diagnosis, which is helpful to identify the benign and malignant thyroid nodules and provides a scientific basis for the early diagnosis of thyroid cancer, further bringing higher clinical application value.