胸腹水细胞沉渣石蜡包埋技术与应用

胸腹水等体液细胞学涂片检查早已广泛应用于临床，方法简单，经济快速，对阴性及大部分阳性胸腹水标本都能够明确诊断，而少部分病例单靠细胞学涂片难以做出明确诊断，往往需借助免疫细胞化学及细胞化学等手段进行鉴别诊断。细胞学涂片难以制出合乎免疫细胞化学要求的多张涂片，且细胞较为分散，面积大，浪费昂贵的免疫组化试剂。为克服这一缺点，我们经过摸索将细胞沉渣进行石蜡包埋、切片，并应用于临床几年来取得了较好的效果。     

培养细胞免疫细胞化学技术的特点与临床应用

培养细胞免疫化学技术作为一种跨领域的研究手段,是将免疫细胞化学技术与细胞培养技术密切结合的技术,可获得单纯从体内实验难以达到的效果。培养细胞免疫组织化学技术与组织切片的免疫组织化学技术基本原理和操作是相同的,但又有许多要特别注意的细节。[第一段]     

乳腺肿块针吸细胞学HE染色涂片的免疫细胞化学染色

细针吸取细胞学 (ｆｉｎｅｎｅｅｄｌｅａｓｐｉｒａｔｉｏｎｃｙｔｏｌｏｇｙ,ＦＮＡＣ)与组织病理学一样 ,在必要时需作各种辅助检查。加特殊染色、免疫组织化学等 ,以助确诊。由于ＦＮＡＣ涂片特点是标本少 ,最多只有 3～ 4张涂片 ,要进行其它检查就只能利用经诊断后的ＨＥ染色的细胞涂片。自开展ＦＮＡＣ以来 ,我们一直有利用ＨＥ染色的细胞涂片作特殊染色或免疫细胞化学(ｉｍｍｕｎｏｃｙｔｏｃｈｅｍｉｓｔｒｙ ,ＩＣＣ)染色。为了方便临床对乳腺癌患者进行术前化疗或非手术患者化疗而提供一些有关内分泌及增殖指数、肿瘤蛋白的表达状…     

免疫细胞化学在细胞病理学中的应用

免疫细胞化学（ICC）在细胞病理学中是一很有用的辅助诊断方法。目前在甲醛固定的石蜡包埋切片和冷冻组织切片中应用的抗体也多数能应用于乙醇或甲醛固定的细胞涂片。免疫细胞化学常用的标本制备方法有4种：直接涂片（CS）法、细胞离心涂片法（cytospin）、细胞块石蜡包埋（CB）法和液基薄层制片法。CS法和细胞离心涂片法由于涂片背景有较多的血细胞、细胞碎片及大量蛋白液,往往出现高背景着色。蛋白质聚集在细胞周围,     

HPV阳性子宫颈病变细胞中HMGA2蛋白的表达及意义

目的探讨HMGA2蛋白在HPV阳性患者子宫颈脱落细胞中的表达及早期诊断的意义。方法根据HPV阳性病例液基细胞学检查的分诊结果,应用免疫细胞化学法检测143例子宫颈脱落细胞HMGA2蛋白表达,其中包含细胞学诊断无子宫颈上皮内病变41例,意义不明确的非典型性鳞状细胞28例,低级别鳞状上皮内病变27例,高级别鳞状上皮内病变33例,鳞状细胞癌14例。结果随访24个月发现HMGA2蛋白表达与子宫颈病变恶性程度相关,阳性率及其强度随子宫颈病变恶性程度的增加而增加,ROC曲线下面积为0.938,敏感性为90.5%,特异性为91.2%;其对组织学阳性的检验效能明显高于单纯的细胞学涂片。结论HMGA2蛋白过表达在子宫颈病变的发生、发展中有重要作用,有利于子宫颈病变的早期诊断,可作为子宫颈癌筛查的新分子标志物。     

CellDetect~染色技术在宫颈脱落细胞诊断中的价值

目的探讨CellDetect染色技术对阴道脱落细胞诊断及鉴别诊断作用。方法采用CellDetect染色对正常细胞和肿瘤细胞中颜色变化和细胞形态的相关性进行分析;并在子宫颈鳞状细胞癌(squmous cells carcinoma,SCC)和高级别上皮内瘤变(cervical intraepithelium neoplasia,CIN)的活检组织切片中比较CellDetect染色和HE染色的效果。结果 (1)手工涂片和TCT涂片的CellDetect染色均能较好的显示细胞的形态学特征,同时显示绝大多数正常鳞状上皮呈蓝色/绿色,子宫颈管上皮细胞呈鲜红色,不典型细胞与癌细胞呈红色。炎症细胞核呈红色,胞质大多数呈绿色/蓝色,红细胞胞质均呈绿色。(2)CIN和SCC的CellDetect染色诊断结果和HE染色诊断结果一致。(3)对子宫颈活检组织的切片和涂片分别行CellDetect染色,结果显示上皮原位细胞颜色反应相同,但CellDetect染色在判断癌与间质的关系或癌间质反应不如HE染色清晰。结论 Cell-Detect染色技术具有颜色和形态双重分析功能,适用于不同形式固定组织的细胞涂片染色,是子宫颈癌筛查和早期诊断的有效工具之一。     

用滤纸法进行脱落细胞学检查的探讨

用于脱落细胞学检查的常规细胞涂片法，常常因为涂片中收集的细胞太少而致癌细胞检查假阴性，而标本中的大量细胞又随残液弃去。为了提高脱落细胞学检查癌细胞的阳性率，首先必须尽可能多地收集标本中的细胞。我们试用滤纸法〔１〕将送检标本进行过滤，基本上能收集标本中...     

用免疫细胞化学鉴别胸腹水脱落细胞在肿瘤诊断中的价值

探讨免疫细胞化学鉴别胸腹水中上皮来源恶性肿瘤细胞和间皮源性细胞的价值。应用免疫细胞化学方法,检测80例患者胸腹水恶性肿瘤细胞和间皮细胞的细胞学形态及ESA、CEA、CK、D2-40、CR、Mesothlial、KI67、Vimentin等8种蛋白的表达情况。结果表明：胸腹水脱落细胞学检测和这8种蛋白联合检测可鉴别上皮来源恶性肿瘤细胞和间皮细胞。两种方法联合检测胸腹水,提高了脱落细胞学疑难病例诊断的准确率。     

Worm-like artifacts in exfoliative cytology

The presence of worms in cytological smears is occasionally reported, although various other structures exist that may be confused with such parasites. We present eight worm-like artifacts observed in routine Papanicolaou smears. Recognition of these structures is important to avoid overvaluation or confusion with true worms.     

Contribution of immunocytochemistry in routine diagnostic cytology

The authors report the experience of applying immunocytochemistry in routine cytological examination and its contribution for diagnosis during a period of 3 yr in Veterans General Hospital-Taipei, Taiwan. From August 1991 to July 1994, the cytology laboratory received 5,762 non-gynecologic specimens with urine excluded. Immunocytochemistry was performed selectively in problematic cases. A total of 215 stainings including 124 epithelial markers, 50 lymphoma/leukemia markers, 22 neuroglial and choroid plexus markers, seven mesenchymal markers, six melanoma markers, and six others was performed on 145 specimens consisting of 89 effusions, 28 fine-needle aspirations, 11 cerebrospinal fluids, and 17 other specimens. Effusions were by far the most frequent specimens for immunocytochemistry and the epithelial markers were the most frequently used antibodies. The immunocytochemical results were essential in 41 specimens (28%), confirmatory in 37 (26%), and non-contributory in 67 (46%). Essential and confirmatory results occurred in 49% of effusions (44/89), 71% of fine-needle aspirations (20/28), 55% of cerebrospinal fluids (6/11), and 47% of other specimens (8/17). It is concluded that immunocytochemistry is proved to be a good aid for the final diagnosis of daily cytologic practices in which the fine-needle aspiration specimens are benefitted best. Diagn Cytopathol 1996;14:221–225. © 1996 Wiley-Liss, Inc.     

Congenital toxoplasmosis: Diagnosis by exfoliative cytology

Toxoplasmosis, caused by the intracellular protozoan Toxoplasma gondii, has as its major routes of acquisition either ingestion (of the cyst or oocyte) or transplacental infection (by trophozoites). Transplacental transmission occurs to the fetus in utero or to the newborn at vaginal delivery. Maternally acquired infections can infect the embryo as early as the 7th week of gestation. It has been estimated that 15–17% of maternal infections acquired between the 7th and 14th weeks of gestation are transmitted to the embryo (Lynfield R, Eaton RB., Teratology 1995;52:176-180.). We present a 7-wk-old white male, delivered at 38 wk of gestation, who shortly after birth was found to have hepatosplenomegaly and anemia; he developed liver failure and ascites with persistent anemia during the first week of life. After an extensive, but nondiagnostic, work-up, a paracentesis was performed which lead to a diagnosis of congenital toxoplasmosis. This case demonstrates the utility of exfoliative cytology in determining the cause of neonatal ascites, especially of an infectious etiology. To our knowledge, this represents the first reported case of Toxoplasma gondii diagnosed by exfoliative cytology in a pediatric patient. Diagn. Cytopathol. 1998;18:357–361. © 1998 Wiley-Liss, Inc.