膜式超薄液基细胞学检测技术在肺癌诊断中的应用

目的 探讨膜式超薄液基细胞学检测技术(TCT)在肺癌诊断中的应用价值.方法 收集143例肺癌患者和139例非肺癌患者的支气管肺泡灌洗液(BALF)和(或)纤维支气管镜刷片标本353个,同时进行TCT和直接涂片法检测,比较两种方法的敏感度和特异度.结果 TCT检测的敏感度为39.6%,特异度为99.4%,直接涂片法检测的敏感度为8.3%,特异度为100%,TCT检测的敏感度高于直接涂片法(P<0.01),特异度差异无统计学意义(P>0.05).BALF的TCT检测敏感度为41.5%,特异度为100%;直接涂片法诊断的敏感度为5.2%,特异度为100%.纤维支气管镜刷片的TCT检测敏感度为35.1%,特异度为96.4%;直接涂片法诊断的敏感度为15.8%,特异度为100%.与直接涂片法比较,两种标本的TCT检测敏感度较高(P<0.01),特异度差异无统计学意义(P>0.05).71例同时采集BALF和纤维支气管镜刷片患者,BALF TCT检测的敏感度(49.0%)高于纤维支气管镜刷片TCT检测的敏感度(32.7%,P<0.05).肺癌患者中,同时有TCT分类诊断和病理组织学诊断结果的标本有69个,TCT分类诊断和病理组织学诊断的总符合率为84.1%.结论 TCT检测能提高肺癌的诊断率,BALF的TCT检测可推广应用于临床.     

支气管刷检液基细胞学在肺癌诊断中的应用价值

目的:探讨支气管刷检液基细胞学在肺癌诊断中的应用价值。方法:支气管刷检标本做液基细胞学检测,剩余标本制作成细胞块切片。结果:液基细胞学诊断肺癌的敏感度、特异度、准确度分别为89.5%、94.3%、91.4%,分型诊断准确率为90.4%。细胞块切片诊断肺癌的敏感度、特异度、准确度分别为95.1%、100%、97.4%,分型诊断准确率为84.6%。两组的敏感度、特异度、准确度及分型诊断准确率比较差异均无统计学意义（P>0.05）。结论:液基细胞学诊断肺癌的敏感度、特异度高,大部分肺癌能准确分型,与细胞块切片合用有互补作用,液基细胞学可作为肺癌早期诊断的有效方法。     

尿液液基薄层细胞学检测联合DNA倍体分析对168例尿路上皮肿瘤诊断的意义

[目的]评价尿液液基薄层细胞学检测(thin-layer cytologital test,TCT)联合DNA倍体分析对尿路上皮肿瘤诊断的意义。[方法]收集2017年6月至2019年5月168例患者,均有血尿(肉眼血尿或镜下血尿)或尿频、尿急、尿痛等排尿症状异常。所有患者均进行病理活检。收集患者早晨第2次新鲜中段尿液分别以传统涂片法、TCT法和TCT联合DNA倍体分析法对尿脱落细胞进行检测,并比较3种检测方法的敏感度和特异性。[结果]168例患者中病理报告尿路上皮肿瘤共62例,传统涂片法、TCT法和TCT联合DNA倍体分析法诊断尿路上皮肿瘤患者的敏感度分别为48.4%(30/62)、69.4%(43/62)和79.0%(49/62)(P<0.05);3种检测方法特异性无统计学差异(P>0.05)。[结论]TCT联合DNA倍体分析法对尿路上皮肿瘤诊断的敏感度高于TCT法和传统涂片法,值得临床推广应用。     

荧光原位杂交在尿路上皮癌诊断中的应用

目的:检测尿路上皮肿瘤患者尿液脱落细胞染色体的缺失和非整倍异常,探讨FISH技术作为尿路上皮肿瘤患者无创诊断方法的价值.方法:收集可疑尿路上皮肿瘤患者和健康对照人群的新鲜尿液,同步进行细胞形态学分析及荧光原位杂交(Fluorescencein situ hybridization,FISH)检测3号、7号及17号染色体、9号染色体p16位点异常.共入选可疑尿路上皮肿瘤患者100例,正常健康对照组20例,采用正常对照组患者各染色体异常数据设定阈值用于肿瘤患者的实验室诊断.根据检验结果与病理结果对照分别计算FISH和脱落细胞的敏感度和特异度并进行统计学分析.结果:与正常对照组相比,尿路上皮肿瘤患者尿液脱落细胞染色体异常明显增多.尿脱落细胞学的敏感度和特异度分别为71%和80%,FISH的敏感度和特异度分别为88%和80%(P<0.01).根据两种检测方法的敏感度和特异度绘制的接受者工作特征(ROC)曲线显示尿脱落细胞学和FISH的曲线下面积分别为0.758和0.842.结论:对可疑尿路上皮肿瘤的患者进行FISH检测是一种有价值的无创检测方法.FISH的总体敏感度高于尿脱落细胞学,特异度与尿脱落细胞学相当.     

液基细胞学检查系统在肺癌诊断中的价值

目的：探讨液基细胞学检查系统在肺癌患者痰液细胞学检查中的应用价值。方法：收集我院2009年送检的痰常规涂片以及痰液基细胞学涂片,由同一医师组筛选出其中的肺癌阳性涂片,并进行分型归纳。结果：13244例痰常规细胞学涂片中诊断肺癌阳性标本454例,阳性率为3.428%,其中鳞癌170例,占常规涂片总量的1.284%,腺癌130例,占常规涂片总量的0.982%。3227例痰液基细胞学涂片中诊断肺癌阳性标本210例,阳性率为6.508%,明显高于常规细胞学涂片检查（P〈0.01）,其阳性标本中鳞癌63例,占痰液基细胞学涂片总量的2.824%,腺癌89例,占痰液基细胞学涂片总量的3.989%;肿瘤科和其他非肿瘤科室送检的痰液基细胞学涂片的肺癌阳性率分别为11.022%和4.121%。结论：痰液基细胞学有助于提高痰液细胞病理学诊断的阳性率,而且可用于肺癌高危人群的筛查和早期诊断。     

肺癌的纤维支气管镜刷细胞学诊断分析

 目的　通过对肺癌的纤维支气管镜刷细胞学诊断的可靠性和可信性的评价及假阳性诊断的探讨 ,提高细胞学诊断的准确性。方法　将 343例中有组织学对照的 2 13例的细胞学诊断与组织学诊断进行比较分析 ,采用 χ2 检验和四格表 ,计算细胞学诊断的敏感度、特异度、假阳性率、假阴性率及符合率。结果　 2 13例细胞学与组织学诊断比较 ,两者差异无显著性 (P >0 .0 5 )。本组细胞学诊断的敏感度94 .5 9% ,特异度 81.5 4 % ,假阳性率 7.89% ,假阴性率 13.11% ,符合率 90 .6 1%。结论　纤维支气管镜刷细胞学是一种诊断肺癌的可靠方法。     

LPT液基细胞学技术在淋巴结穿刺诊断中的应用

目的:探讨LPT液基细胞薄片技术在淋巴结穿刺标本中的诊断应用价值.方法:利用利普(LiquidPrep Test,LPT)液基细胞薄片技术和传统制片技术对310例淋巴结肿大的细针穿刺标本进行对比分析.从涂片的细胞量,细胞形态结构,涂片背景等方面进行比较.结果:在涂片质量方面,LPT液基细胞薄片优于传统涂片组,但两种检查方法的结果无统计学意义(P>0.05).结论:LPT液基薄片细胞制片在细胞量、细胞形态保存和涂片背景清晰方面优于传统涂片,有助于提高病理医师阅片的快速性和准确性.传统涂片细胞核结构较清晰.两者结合应用,有助于提高淋巴结病变诊断的准确性.     

液基细胞学检测对痰脱落细胞诊断的研究

为探讨液基细胞学检测系统在痰脱落细胞学诊断中的效果,我们使用国产手工液基细胞学系统对118例临床可疑为肺癌的痰标本进行了液基细胞学涂片法处理并与传统细胞涂片方法对比。应用液基薄层细胞涂片法在痰标本中查到恶性肿瘤细胞39例,可疑瘤细胞3例,传统涂片19例被漏诊。液基细胞涂片法诊断灵敏度提高了24.5%。初步研究结果提示,痰液基细胞学涂片质量明显优于常规涂片。初次开展者可将其与传统检查方法对照应用。     

非妇科领域应用液基细胞学与传统涂片细胞学参数的比较研究

目的通过液基制片(LBP)方法在非妇科脱落细胞学胸腹水领域中的应用,探讨液基细胞学制片方法在非妇科脱落细胞领域制片的优缺点及其应用前景。方法对本院25例胸腹水,应用液基制片,并同步与传统涂片进行了细胞形态学观察,免疫组化染色和荧光原位杂交(FISH)检测,并应用图像分析系统加以定量对比分析。结果定性观察发现,液基制片的细胞明显比传统涂片的细胞变小,细胞形态也发生了一定的变化;免疫组化LCA、EMA、Vim和PCNA染色与传统涂片染色未见明显不同,FISH检测结果,除酶消化时间较传统涂片延长5 min外,其他未见明显不同;细胞定量结果发现,液基制片的细胞面积比传统制片的细胞面积减少了58.1%(P<0.01),细胞周长减少了42.7%(P<0.01),细胞等效直径缩短了37.5%(P<0.01),细胞长径缩短了37.4%(P<0.01),细胞短径也缩短了37.8%,细胞长短径之比未见明显差异(P>0.05)。液基制片的细胞形状因子减小了18.12%(P<0.01),细胞圆形度增加了13.7%(P<0.01),细胞平均光度增加了57.1%(P<0.01),细胞积分光度减少了41.5%(P<0.01),细胞平均灰度未见明显差异(P>0.05)。结论液基细胞学制片明显缩小了目标细胞,其形态也发生了较明显改变,但不影响测试细胞进一步的免疫组化染色和FISH检测,在非妇科脱落细胞学领域的应用,对诊断医师具有较高适应训练要求,也仍具有进一步改进的空间。     

DNA倍体分析对液基细胞学在良恶性胸腹水诊断中的支持价值

目的:探讨液基细胞学、肿瘤标志物和DNA倍体分析单独和联合在良恶性胸腹水诊断中的鉴别价值。方法:收集312例同时做过胸腹水液基细胞学检查、DNA倍体分析和血清肿瘤标志物检测的病例,且所有病例都有组织病理诊断结果,对这些指标及人口统计学特征进行分析;基于液基细胞学、肿瘤标志物、DNA倍体分析单独及其组合的诊断,通过Logistic回归建立组合模型,并通过ROC曲线下面积(AUC)进行比较,以及计算其对应的敏感度(SE)、特异度(SP)、阳性预测值(PPV)和阴性预测值(NPV)。结果:以组织病理诊断结果为金标准,液基细胞学、肿瘤标志物和DNA倍体分析的AUC值分别是0.702、 0.512、0.776;模型1(液基细胞学联合肿瘤标志物)AUC值为0.722,SE为49.8%,SP为90.6%,PPV为79.5%,NPV为24.5%;模型2(液基细胞学联合DNA倍体分析)AUC值为0.783,SE为68.7%,SP为83.00%,PPV为95.2%,NPV为35.2%;模型3(模型2联合肿瘤标志物)AUC值0.776,SE为58.7%,SP为88.7%,PPV为85.3%,NPV为29.8...     

Efficacy of nasal cytology

Nasal Cytogram is a simple, economical and reliable investigation. Although its utility was recognised as early s1927, it has not gained much popularity. Here an attempt is madeto assess the efficacy of nasal cytology in the light of histology, to diagnose various nasal conditions.127 cases of common rhinological problem were studied at Govt. Medical College, Nagpur. This investigation was found to be simple, reliable & economical.     

Changing the cytology laboratory information system to improve cytology performance

A central tenet in the Patient Protection and Affordable Care Act is the increased use of information technology to improve patient care. However, areas for improvement in cytology are not well defined. Improvements in information technology could improve quality assessment in gynecologic cytology, but the cytology community must identify and ask for changes in information technology that can improve the care of patients. Cancer (Cancer Cytopathol) 2014;122:87–91. © 2013 American Cancer Society.     

Liquid-based cervical cytology

BACKGROUND: The objective of the current study was to evaluate the applicability of liquid-based cytology in the Netherlands population screening program for cervical cancer. METHODS: A special committee performed an evaluation of all the available literature. Two methods were investigated: the AutoCytePrep system (currently known as ShurePath-system; TriPath Imaging, Burlington, NC) and the ThinPrep system (Cytyc, Boxborough, MA) for the detection of squamous epithelial abnormalities. All literature up to May 2000 was evaluated. RESULTS: For the AutoCytePrep system, there were indications that the detection rate for atypical squamous cells of undetermined significance (ASCUS) or higher had lower sensitivity compared with conventional screening. No definitive statement could be made concerning the value of the AutoCytePrep system for the detection rate of low-grade squamous intraepithelial lesions (LSIL) or higher and high-grade squamous intraepithelial lesions (HSIL) or higher because of conflicting results. For the ThinPrep system, there were indications that the detection rate of ASCUS or higher had a higher detection rate compared with conventional screening, with slightly lower specificity. It is likely that the detection rate of LSIL or higher with the ThinPrep system had greater sensitivity compared with conventional screening with almost unchanged specificity. In addition, it is likely that the detection rate of HSIL or higher with the ThinPrep system had a higher detection rate and greater absolute sensitivity compared with conventional screening with almost unchanged relative and absolute specificity. CONCLUSIONS: Further research that complies with the standards stated in the current study will be necessary to evaluate the applicability of the AutoCytePrep method. Further evaluation of the costs and benefits of the ThinPrep method should be undertaken to decide definitively whether to implement this method in the Netherlands population screening program.     

Interrater agreement of anal cytology

BACKGROUND:

The majority of anal cancers are caused by persistent infections with carcinogenic human papillomaviruses (HPV). Similar to cervical carcinogenesis, the progression from HPV infection to anal cancer occurs through precancerous lesions that can be treated to prevent invasion. In analogy to cervical cytology, anal cytology has been proposed as a screening tool for anal cancer precursors in high‐risk populations.

METHODS:

The authors analyzed the interobserver reproducibility of anal cytology in a population of 363 human immunodeficiency virus (HIV)‐infected men who have sex with men (MSM). Liquid‐based cytology (LBC) specimens were collected in the anal dysplasia clinic before the performance of high‐resolution anoscopy on all patients. Papanicolaou‐stained LBC slides were evaluated by 2 cytopathologists, each of whom was blinded to the clinical outcome and the other pathologist's results, using the revised Bethesda terminology.

RESULTS:

Overall agreement between the 2 observers was 66% (kappa, 0.54; linear‐weighted kappa, 0.69). Using dichotomizing cytology results (atypical squamous cells of undetermined significance [ASC‐US] or worse vs less than ASC‐US), the agreement increased to 86% (kappa, 0.69). An increasing likelihood of testing positive for markers associated with HPV‐related transformation, p16/Ki‐67, and HPV oncogene messenger RNA was observed, with increasing severity of cytology results noted both for individual cytologists and for consensus cytology interpretation (P value for trend [p_trend] < .0001 for all).

CONCLUSIONS:

Moderate to good agreement was observed between 2 cytopathologists evaluating anal cytology samples collected from HIV‐positive MSM. A higher severity of anal cytology was associated with biomarkers of anal precancerous lesions. Anal cytology may be used for anal cancer screening in high‐risk populations, and biomarkers of HPV‐related transformation can serve as quality control for anal cytology. Cancer (Cancer Cytopathol) 2013. Published 2012 by the American Cancer Society.     

DNA定量细胞学配合液基细胞学对宫颈病变筛查的价值

目的:评价DNA定量细胞学配合液基细胞学检查在宫颈癌防治中的价值。方法:收集2009-01-01-2010-10-31在我院妇科门诊行液基细胞学及DNA定量检查的患者4 352例,对检查结果建议为活检的病例504例行阴道镜检查及活体组织检查,常规HE染色后观察病变程度,分别计算其与液基细胞学和DNA Feulgen染色后的阳性率。结果:以TBS活检标准行活检病例的阳性检出率为52.18%(263/504),以DNA定量分析结果活检标准行活检的病例阳性检出率为66.67%(336/504),经2种细胞学方法联合建议取活检后,其阳性检出率为81.75%(412/504),3种方法两两比较,差异有统计学意义,P<0.05。结论:DNA Feulgen染色和液基细胞学联合检测既能降低宫颈液基细胞学的假阴性率,又能提高宫颈早期病变的检出率,为防止宫颈早期病变进一步发展为癌起到一定的积极作用。