荧光快速现场评价在恶性胸膜疾病中的应用初探

目的 探索改进型吖啶橙荧光染色法作为现场快速评价诊断恶性胸膜疾病的可行性。方法 选择2017年6月~2019年12月在中国人民解放军第903医院收治的不明原因胸腔积液患者32例，均行内科胸腔镜检查及快速现场评价(rapid on-site evaluation, ROSE)检查。对现有的吖啶橙染色进行改进，与迪夫快速染色法（Diff-quikstain）比较两者在操作时间、判断简易程度、与最终病理的一致性等方面的差异，对新型荧光快速现场评价的细胞学特征进行总结、归纳。结果 经吖啶橙染色后，肿瘤细胞可较为容易的与正常细胞区别开来，并且有一定的特征性表现。与迪夫染色法相比，两种染色法在敏感度、特异度、阳性预测值、阴性预测值、最终病理结果符合率方面无统计学差异，但是改进型吖啶橙染色法操作更简易，判读时间更短，鉴别肿瘤细胞更加容易，并且无有毒气体挥发。结论 改进型吖啶橙染色法具有简易、快速、精准等优点，可用作快速现场评价。

The clinical application of rapid on-site evaluation based on fluorescence staining in malignant pleural disease

Objective To explore the feasibility of an improved acridine orange fluorescent staining method as a field for rapid diagnosis of malignant pleural diseases. Methods Thirty-two patients with unexplained pleural effusion who were admitted to the 903 Hospital of the People''s Liberation Army from June 2017 to March 2020 were selected for medical thoracoscopy and rapid on-site evaluation (ROSE). Improve the existing acridine orange staining, compare the differences in operation time, ease of judgment, and consistency with the final pathology with Diff-quikstain method, and evaluate the rapid on-site evaluation of new fluorescence Summarize and summarize the cytological characteristics. Results After staining with acridine orange, tumor cells can be easily distinguished from normal cells and have certain characteristic performance. Compared with the Diff staining method, the two staining methods have no statistical differences in sensitivity, specificity, positive predictive value, negative predictive value, and the final pathological result coincidence rate, but the improved acridine orange staining method is easier to operate and the interpretation time Shorter, easier to identify tumor cells, and no toxic gas volatilization. Conclusion The improved acridine orange staining method has the advantages of simplicity, speed and accuracy, and can be used for rapid on-site evaluation.