胰腺细针穿刺活检标本三种固定方法的实验研究

目的:探索对内镜超声引导下细针穿刺活检(FNA)获取的胰腺组织的有效固定方法,以提高病理学诊断准确率。方法:应用Wilson-Cook公司的19G超声内镜专用穿刺针对20例胰十二指肠大部切除术获取的新鲜胰腺标本进行体外模拟穿刺,将所获得的穿刺组织按固定方法不同随机分为三组,福尔马林直接固定组(A组)、组织胶粘合后福尔马林固定组(B组)及液基细胞固定组(C组)。送病理科制片后,病理学家根据病例片中组织的完整性及血液细胞污染程度对病理片质量进行评分。结果:三组总分分别有显著统计学差异(P<0.0001),组织量评分分别有显著统计学差异(P=0.0046),血液细胞污染评分分别有极显著统计学差异(P<0.0001)。结论:胰腺穿刺组织经组织胶粘合后福尔马林固定为最佳的固定方式,可以最大程度地减少在组织学检查取样过程中组织的丢失,较好地减少血液细胞污染,所得到标本的完整性最好,有利于提高组织病理学的诊断率。

Comparisons of Three Ways to Fix FNA Tissues of Pancreatic Tissue for Histology Diagnosis:Using A Vitro Mimic FNA Method

Objective:The objective of this study was to find a better method for preparation of tissues from fi ne needle aspiration biopsy(FNAB) of pancreatic tissue,in order to make a better histology diagnosis.Methods:By vitro mimic FNA method,we obtained fine pancreatic tissue samples from 20 cases of duodenopancreatectomy operations with a 19-gauge needle(Echotip,Wilson-Cook,USA).Three groups were divided according to fixation methods:formalin fixation(group A),Tissue-Tek embedding combined with formalin fixation(group B) and Thin-Prep(TP) preparation(group C).The tissue obtained was for histology preparation,and slides were reviewed blindly by two cytopathologists.Scores were made according to tissue integrity and blood contamination.Result:There were significant differences among the three gruops in total scores(P<0.0001),tissue integrity scores(P=0.0046) and blood contamination scores(P<0.0001).Conclusion:Embedding medium Tissue-Tek with formalin preparation,which could maximize the tissue amount obtained and reduce blood contamination,was superior to directly formalin fixation and Thin-Prep(TP) cytological preparation.