星形细胞肿瘤术中细胞学诊断的探讨

目的　探讨星形细胞肿瘤的术中细胞学形态特点及细胞学分级诊断的可能性。方法　采用压片法进行细胞学涂片 ,HE染色 ,以组织病理学诊断为对照 ,光镜下观察星形细胞肿瘤的细胞学形态特点。结果　星形细胞肿瘤的细胞学特征是背景出现胶质纤维网。其中毛细胞型为瘤细胞两端伸出细长的发丝样纤维 ,散在Rosenthal纤维和嗜酸性蛋白小滴 ;弥漫性细胞较稀疏 ,几乎不见核分裂象 ;间变性细胞较丰富 ,核分裂象易见 ;多形性胶质母细胞瘤可见片状坏死或大量厚壁血管增生。本组星形细胞肿瘤细胞学诊断准确率为 96 2 % ,细胞学与组织学分级一致率为 84 6 %。结论　星形细胞肿瘤的术中细胞学涂片结构清晰、诊断准确、分级可靠 ,与术中冷冻切片相比有一定的优势。

Intraoperative cytological diagnosis of astrocytic tumors

Objective To investigate the application of the intraoperative cytological features in the diagnosis and grading of astrocytic tumors. Methods Smear was prepared by extrusion and stained with H-E, and the cytological features of astrocytic tumors were observed with comparison to histological changes of the tumor. Results The cytological features of astrocytic tumors was appearance of gluey fibrous net in its background. The features of diffused astrocytic tumors included abundant cells and few mitosis; That of anaplastic astrocytic tumors included more abandant cells and easily-found mitosis; Glioblastoma multiforme had sheet necrosis and large think wall blood vessels. The correct rate of cytological diagnosis was 96.2%, and the grading in 84.6% cases was consistant with histology. Conclusion The intraoperative cytological diagnosis is exact and its grading diagnosis is also reliable, and it can replace the frozen section.