胸腹心包腔积液恶性细胞分析

目的:收集2002年1月至2003年12月2240例胸腹心包腔积液中查见470例恶性细胞分析,探讨积液常规检查的细胞形态学诊断价值。方法:浆膜腔积液常规检查的制片采用推片法,涂片染色采用瑞吉复合染色法,通过有经验的细胞学学者鉴定细胞性质。结果:在2240例胸腹心包腔积液常规检查细胞形态学分析中检出恶性细胞342例,与临床最终诊断恶性肿瘤的符合率为98.8%;检出44例可疑恶性细胞中与临床最终诊断恶性肿瘤的符合率为88.6%;122例核异质细胞中确诊为恶性肿瘤71例,与临床确诊符合率为58.2%;检出恶性淋巴瘤细胞14例、白血病细胞5例、骨髓瘤细胞1例、恶性间皮瘤2例,与临床终诊符合率为100%;并对448例胸腹心包腔积液恶性细胞分型:其中腺癌398例、鳞癌33例、未分化癌17例。结论:在浆膜腔积液常规检查中,开展细胞形态学检查十分重要,特别要重视积液涂片的细胞形态学观察,在积液常规检查中提高恶性细胞(包括肿瘤细胞、白血病细胞、淋巴瘤细胞、骨髓瘤细胞等)的检出率,对于临床诊断及治疗有重要意义。

Analyses of Malignant Cell of Pleural Effusion,Ascites and Pericardial Effusion

Objective Through finding and analising 470 cases of Malignant cell of pleural effusion,ascites and perieardial effusion in 2 240 cases from January,2002 to December,2003,to discuss the cytomorphological diagnostic value of routine dropsyexamination on the basis of cytomorphological analyses.Methods The routine examination of serous membrane effusion are based on smearing and Wright-Giemsa staining,the character of cells were evaluated by veteran in the field of cytodiagno- sis.Results Cytomorphological analyses of pleural effusion,ascites and pericardial effusion specimens from the 2 240 cases re- vealed malignant cells in 342 cases,suspected malignant cells in 44 cases,and nuclear heterogeneous cells in 122 eases,71 of which were confirmed to be malignant tumors,the coincidence rate against the finally confirmed clinical diagnosis being 98. 8%,88.6% and 58.2% respectively.Malignant lymphocytes were detected in 14 cases,leukemic cells in 5 cases,marrow tumor ome case and malignant mesothelioma cells in 2 cases,the coincidence rate against the finally confirmed clinical diagno- sis being 100% and there were 398 Adenocarcinoma,33 Squamouscareinoma、17 Indifferentiate carcinoma in the 448 cases. Gonclusion Cytomorphological analysis is important in routine examination of serous cavity dropsy,especially the cytomorpho- logical diagnostic value of routine dropsyexamination on the basis of pleural effusion,ascites and perieardial effusion speci- mens,this is of great significance for clinical diagnosis and treatment,to improve the rate of inspcting malignant cells(tumor cells lymphocytes leukemice cells marrow tumor cells ect).