细胞病理学刮片在皮肤和黏膜病变检查中的应用及体会附148例细胞学与组织学对照

目的探讨细胞病理学刮片方法在皮肤和黏膜病变诊断中的可靠性、实用性和局限性。方法比较使用不同标本采集方法（载玻片刮片、压舌板刮片和针吸涂片）获取18例皮肤和黏膜恶性肿瘤的细胞数量;对456例皮肤和黏膜病变行刮片检查,其中148例获得组织病理学核对。结果载玻片刮片法对皮肤和黏膜恶性肿瘤的细胞获取量最满意;其诊断良性病变的特异性为100％（37／37）,诊断恶性肿瘤的敏感性92．8％（103／111）,诊断的总准确率94,6％（140／148）;假阴性率为7．2％（8／111）,假阳性率为0,总误诊率为5．4％（8／148）。结论在皮肤和黏膜病变细胞病理学检查中,采用载玻片刮片法具有操作简便、安全及获取细胞量充分,诊断准确率较高,应用范围广等优点;但存在一定的局限性,需要通过组织病理学诊断解决。

Cytopathological scrape examination of superficial lesions of skin and mucosal membrane--a cytological and histological comparative study of 148 cases

Objective To investigate the reliability, practicability and limitations of cytopathological scrape method in the diagnosis of superficial lesions of skin and mucosal membrane. Methods The quantity of cells harvested by different collecting methods were compared in 18 cases of malignant tumors of the skin and mucosal membrane. The scrape method was performed in 456 cases, of which 148 cases had corresponding histological specimens.Results Glass slide scraping provides the most satisfactory cell numbers from the lesions of skin and mucosal membrane. The specificity for diagnosing benign lesion in 37 patients was 100% and that for diagnosing malignant tumors in 111 patients was 92.8%(103). The overall diagnostic accuracy was 94.6%(140/148). The false negative rate, false positive rate and the overall misdiagnostic rates were 7.2% (8/111), 0, and 5.4%(8/148)respectively. Conclusions For cytopathological examination of superficial skin and mucosal membrane lesions, the glass slide scraping method provides broad applications with high diagnostic accuracy and advantages of simplicity, safety and efficiency. Certain limitations do exist, but can be resolved by histological examination of the lesion.