细针吸取细胞块技术在体表淋巴结肿块诊断中的应用

目的探讨细针吸取细胞学检查中联合应用细胞块切片技术对体表淋巴结肿块诊断的价值。方法选取经活检组织学对照且细针吸取细胞学常规涂片阳性的患者60例，均行二次细针吸取细胞制做细胞块石蜡切片检查，疑难病例加做免疫细胞化学染色，比较联合细胞块切片诊断结果与单纯常规涂片细胞学检查结果，分析两者诊断准确性。结果单纯常规细针吸取细胞学涂片，诊断腺癌与活检组织学诊断符合率为65．4％（17／26），诊断鳞癌符合率为70．O％（14／20）；联合细胞块切片诊断腺癌与组织学诊断符合率为96．2％（25／26），诊断鳞癌符合率为95．O％（19／20），两者比较差异有统计学意义（P〈0．05）。常规细胞学分类不明确诊断20例，占33．33％，联合细胞块分类不明确诊断7例，占11．7％。结论细针吸取细胞学检查中联合应用细胞块切片技术能明显提高转移癌尤其腺癌和鳞癌的诊断正确率，并能进行免疫细胞化学染色，在肿瘤分型和分类中具有较高的应用价值，但该技术对恶性淋巴瘤及少见疑难肿瘤的诊断仍存局限性。

Diagnostic value of fine needle aspiration of cell block in the assessment of superficial lymph node masses

Objective To investigate the diagnostic value of fine needle aspiration of cell block （FNACB） combined with fine needle aspiration cytology （FNAC） in diagnostis of the superficial lymph nodes. Methods Sixty patients whose enlarged superficial lymph nodes were identified as positive by FNAC received FNACB and subsequent biopsies were performed. The difference of the diagnostic accuracy rate between FNAC smears and FNACB combined FNAC smears were compared. ICC was performed to some poorly differentiated malignant tumors which prepared for cell blocks. The date was managed statistically. Results Compared with histopathological results,the diagnostic ac- curacy rate of FNAC routine smears as follows： squamous cell carcinoma （SCC）, 70. 0% （14/20） ; adenocarcinoma （AC） ,65.4% （17/26） ; indefinite ceil types diagnosis,20 cases（33. 3% ）. The diagnostic accuracy rate of FNACB combined FNAC routine smears as follows： SCC ,95.0% （19/20） ; AC ,96. 2% （25/26） ; indefinite cell types diag- nosis,7 cases （ 11.7% ）. There was a statistical difference between them （ P 〈 0. 05 ）. Conclusion Application of ceil block compared with FNAC in diagnosis of the superficial lymph nodes can significantly increase the diagnostic accuracy rate of lymph node metastatic carcinomas, especially for SCC and AC, and have a high applied value in his- tological typing and classification, but there are still some limitations in diagnosis of malignant lymphomas and some rare metastatic carcinomas.