摘要
目的 采用细胞蜡块制片法对子宫内膜脱落细胞做细胞学诊断,分析该技术在子宫内膜癌筛查中的应用价值。方法 应用子宫内膜采集器收集355例子宫内膜脱落细胞样本,先行液基细胞学涂片,剩余标本提取其沉渣作细胞蜡块HE制片,并以双盲法分别评估两种制片方法的满意率,两种细胞学诊断的灵敏度、特异度、阳性预测值、阴性预测值、准确率以及细胞学与组织学诊断符合率。对有诊断性刮宫或子宫切除的病例,追踪其子宫内膜组织活检诊断结果,并将3种诊断结果进行对比分析。结果 观察对象355例,细胞蜡块制片满意率为89.30%(317/355),高于液基细胞学制片满意率[81.12%(288/355)],差异有统计学意义(χ^(2)=9.40,P<0.005)。355例病例中,143例有对应的组织活检结果,细胞蜡块和液基细胞学与组织学诊断的符合率分别为97.2%(139/143)和89.5%(128/143),差异有统计学意义(χ^(2)=4.24,P<0.05)。液基细胞学、细胞蜡块的诊断灵敏度、特异度、阳性预测值和阴性预测值分别为56%和88%、96.6%和99.1%、77.8%和95.7%、91.2%和97.5%。细胞蜡块和液基细胞学诊断子宫内膜癌及不典型增生的准确率分别为88%和56%,差异有统计学意义(χ^(2)=6.82,P<0.01)。结论 子宫内膜细胞蜡块制片法在子宫内膜癌筛查中有较高的灵敏度和特异度,可提高子宫内膜癌筛查的准确率,尤其在检出子宫内膜癌和不典型增生方面优于液基细胞学制片,具有较高的临床应用价值。
Objective To investigate cell block method in the cytological diagnosis of endometrial exfoliated cells and its application value in endometrial cancer screening. Methods The endometrial collector was used to collect 355 samples of exfoliated cells of endometrium, which were smeared by liquid-based cytology first, and the sediment of the remaining samples was extracted and made into cell wax blocks for HE production. The satisfactory rate of the two method, the sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate and the coincidence rate between cytology and histology were evaluated by double blind method. For cases with diagnostic curettage or hysterectomy, the diagnosis result of endometrial biopsy were tracked, and the three diagnosis results were compared and analyzed. Results A total of 355 cases were observed, and the satisfactory rate of cell wax block preparation was 89.30%(317/355), which was higher than that of liquid-based cytology(81.12%, 288/355), and the difference was statistically significant(χ^(2)=9.40, P<0.005). Among the 355 cases, 143 cases had corresponding biopsy result, the coincidence rates of cell wax block and liquid-based cytology with histological diagnosis were 97.2%(139/143) and 89.5%(128/143), respectively, and the difference was statistically significant(χ^(2)=4.24, P<0.05). The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of liquid-based cytology and cell wax block were 56% and 88%, 96.6% and 99.1%, 77.8% and 95.7%, 91.2% and 97.5%, respectively. The accuracy rates of wax block and liquid-based cytology in diagnosing endometrial carcinoma and atypical hyperplasia were 88% and 56%, respectively, and the difference was statistically significant(χ^(2)=6.82, P<0.01). Conclusion The wax block method of cells has high sensitivity and specificity in endometrial cancer screening, which can improve the accuracy of endometrial cancer screening, especially in the detection of endometrial cancer and atypical hyperplasia;it is superior to liquid-based cytology preparation method and has high clinical application value.
作者
梁储财
邵少慰
LIANG Chu-cai;SHAO Shao-wei(Department of Pathology,Zhaoqing Second People's Hospital,Zhaoqing 526 China)
出处
《诊断病理学杂志》
2022年第12期1148-1151,共4页
Chinese Journal of Diagnostic Pathology
关键词
细胞蜡块
液基细胞学
子宫内膜癌
筛查
Cell wax block
Liquid cytology
Endometrial carcinoma
Screen
作者简介
通讯作者:邵少慰。E-mail:shaoweishao@163.com。
