摘要: |
[摘要] 目的 探讨细胞块病理技术在恶性浆膜腔积液细胞学诊断应用中的价值、存在的问题及质控方法,以进一步提高细胞块病理诊断的准确性。方法 选择2016-02~2018-02该院276例恶性浆膜腔积液,均进行传统细胞学涂片(conventional smear,CS)和质控前常规细胞块技术(routine cell block,RCB)操作流程,对RCB切片诊断中可疑或阴性病例按预设5项主要质量控制指标再行质控后细胞块制备技术(quality control in cell block technology,QCCB)切片检查,将三者诊断结果进行对比分析,比较三者结果的准确性,分析各自存在的问题。结果 276例恶性浆膜腔积液中用CS确诊恶性肿瘤218例(78.99%),其中确诊恶性且肿瘤分类明确199例(72.10%)。RCB确诊恶性肿瘤233例(84.42%),其中确诊恶性且肿瘤分类明确225例(81.52%)。QCCB确诊恶性肿瘤272例(98.55%),其中确诊恶性且肿瘤分类明确270例(97.83%),无误诊或漏诊病例。RCB相对于CS能提高恶性肿瘤诊断率5.43%,提高分型诊断准确率9.42%,但两者差异无统计学意义(P>0.05)。QCCB相对于CS和RCB,在提高确诊恶性肿瘤和分型诊断准确率方面差异均有统计学意义(P<0.05)。结论 细胞块技术在恶性浆膜腔积液细胞学病理诊断中显著优于传统细胞学,加强细胞块病理技术各环节质量控制有利于减少不确定诊断,并有助于避免误诊和漏诊。 |
关键词: 浆膜腔积液 细胞学涂片 细胞块 质量控制 |
DOI:10.3969/j.issn.1674-3806.2020.10.21 |
分类号:R 362 |
基金项目: |
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A study on the efficiency of cell block technology in diagnosis of malignant serous cavity effusions by using quality control methods |
LI Yin, GAO Li, HE Hai-sheng
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Department of Pathology, Nanyang Central Hospital, Henan 473000, China
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Abstract: |
[Abstract] Objective To explore the application value, existing problems and quality control methods of cell block pathologic technique in cytological diagnosis of malignant serous cavity effusions(SCE) to further improve the accuracy of cell block pathologic diagnosis. Methods Two hundred and seventy-six cases of malignant SCE were selected in our hospital during February 2016 and February 2018 for the operation process of conventional smear(CS) and routine cell block(RCB) technology before quality control. For the suspicious or negative cases by the diagnosis of RCB slice, quality control in cell block technology(QCCB) was performed again for pathology slice examination according to the preset 5 main quality control indexes. The results of the three diagnosis methods were compared and analyzed, and the accuracy of the three methods was compared, and their existing problems were analyzed. Results Among the 276 cases of malignant SCE, 218 cases(78.99%) were diagnosed with malignant tumors by using CS method, in which 199 cases(72.10%) were diagnosed with definite tumors(clear classification), while 233 cases(84.42%) were diagnosed with malignant tumors by using RCB method, in which 225 cases(81.52%) were diagnosed with definite tumors(clear classification). By using QCCB method, 272 cases(98.55%) were diagnosed with malignant tumors, in which 270 cases(97.83%) were diagnosed with definite tumors(clear classification), and no misdiagnosis or missed diagnosis occurred. Compared with CS, RCB can improve the diagnosis rate of malignant tumors by 5.43% and the accuracy rate of classification diagnosis by 9.42%, but there were no significant differences between the two methods(P>0.05). Compared with CS and RCB, QCCB had significant differences in improving the accuracy of diagnosing and classifying the malignant tumors(P<0.05). Conclusion Cell block technology is significantly superior to conventional smear in cytological and pathological diagnosis of malignant SCE. Strengthening the quality control of cell block technology in all linkages is helpful to reduce uncertain diagnosis and avoid misdiagnosis and missed diagnosis. |
Key words: Serous cavity effusions(SCE) Cytological smear Cell blocks Quality control |