艾滋病患者体表针吸活检病理诊断精确性研究

目的本研究分析了艾滋病患者体表淋巴结、皮肤黏膜肿物针吸细胞学病理的精确性、敏感性、特异性、阴性/阳性预测值,同时分析艾滋病针吸细胞学病理的常见疾病谱。方法对85例艾滋病针吸细胞学病理标本进行分析,将病理结果分为阳性、阴性、可疑阳性和诊断不满意,并和临床病原学检查、临床疗效和随访结果进行对比。结果 85例艾滋病针吸细胞学病理结果显示精确性、敏感性、特异性、阳性和阴性预测值分别为87.1%[95%CI(0.78,0.94)]、85.7%[95%CI(0.77,0.94)]、90.9%[95%CI(0.79,1.00)]、96.4%[95%CI(0.92,1.00)]和69.0%[95%CI(0.52,0.86)];艾滋病患者体表淋巴结、皮肤黏膜肿物针吸细胞学病理结果以淋巴结结核为主,其次为鸟分枝杆菌感染、马尔尼菲青霉菌感染、隐球菌感染,体表弥漫大B型淋巴瘤和伯基特淋巴瘤也可通过针吸细胞学病理诊断。结论本研究发现艾滋病针吸细胞学活检病理精确性、特异性、敏感性和阳性预测值高,对艾滋病机会性感染和肿瘤的诊断帮助较大;但阴性预测值低,要警惕假阴性结果的出现。

Needle Aspiration Biopsy for Pathological Diagnosis in AIDS Patients

Objective To evaluate the accuracy,sensitivity,specificity,negative/positive predictive value of fine needle aspiration(FNA) for cytological assessment in lymphadenopathy and mucocutaneous mass in AIDS patients,and to study the cytological spectrum of diseases found with FNA. Methods Totally 85 cytological specimens were collected and their cytological results were classified as positive,negative,suspicious and unsatisfactory diagnosis.The cytological results were compared with the results of clinical aetiology,curative effects and follow-up. Results The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FNA were 87.1%[95%CI(0.78,0.94)],85.7%[95%CI(0.77,0.94)],90.9%[95%CI(0.79,1.00)],96.4%[95%CI(0.92,1.00)]and 69.0%[95%CI(0.52,0.86)],respectively.The FNA cytological results were mainly lymphoid tuberculosis,followed by infections of mycobacterium avium,penicillium marneffei and cryptococcus.And the larger diffuse lymphoma and Burkitt’s lymphoma could also be diagnosed by FNA. Conclusion FNA has high percentages of accuracy,sensitivity,specificity and positive predictive value,and it is helpful for diagnosis of opportunistic infection and tumor in AIDS patients.Nevertheless,attention of false negative result needs to be paid.