液基细胞学检查系统在肺癌患者痰液检查中的临床应用价值

背景与目的传统的痰涂片内常混有大量粘液、血液、各种炎性细胞及坏死细胞碎屑，故阳性诊断率较低。液基细胞学检查系统（liquid-based cytologic test，LCT）已成功而广泛地应用于官颈细胞学诊断，而用于痰液细胞学诊断国内外报道均较少。本研究的目的是探讨LCT在肺癌患者痰液检查中的应用价值，寻找早期诊断肺癌的新途径。方法比较LCT与传统痰涂片方法应用于肺癌诊断的镜下特点及诊断率。结果LCT法涂膜面积明显缩小。背景干净，图像清晰，三维立体感突出。LCT对小细胞肺癌的诊断率显著高于传统涂片法（P〈0．05）。LCT与传统涂片法联合应用后，对肺癌的阳性诊断率可高达85．1％，明显优于单纯的传统涂片法（63．4％）（P〈0．01）。结论LCT在痰液制片、染色等方面便于实施质量控制，是值得推广的一种新技术，与传统涂片法联合应用具有重要的临床价值。

Clinical value of liquid-based cytologic test in sputum examination of patients with lung cancer

Background and objective There are lots of mucus, blood, inflammatory cells and necrotic material in the pick-and-smear slides, resulting in a low detection rate. Liquid-based cytologic test (LCT) has been applied for cervical cytology diagnosis successfully and widely, however it is few reported yet for sputum cytology diagnosis at present. The aim of this study is to evaluate the clinical value of LCT in sputum examination of patients with lung cancer, and to find a novel method of early diagnosis of lung cancer. Methods The cytologic findings and the diagnostic rate for lung cancer were compared between LCT and conventional pick-and-smear method. Results There were smaller area of smear membrane, clearer background, more distinctly cytologic picture and stereoscopic fell by LCT comparing with pick-and-smear method. The diagnostic rate for small cell lung cancer by LCT was significantly higher than that by pick-and-smear method (P<0.05). After combined detection of the two methods, the diagnostic rate for lung cancer was obviously improved (85.1%), which was remarkably higher than that by pick-and-smear method alone (P<0.01). Conclusion It is operated easily for LCT to be well controlled in making smear and dyeing. LCT may be a novel technique worthy of wide use. Combination of LCT with pick-and-smear method appears to be of great value in clinical application.