淋巴结转移性鼻咽癌针吸检查中细胞块样本的应用

发布时间：2019-04-13 12:40

【摘要】：目的探讨细针吸取(FNA)涂片联合细胞块(CB)切片、免疫组化标记(IHC)和EBER原位杂交在淋巴结转移性鼻咽癌中的应用。方法采用友谊式细针穿刺器和21G注射针对31例鼻咽癌头颈部淋巴结转移病灶获取样本制片,观察其细胞形态学及CB组织形态学特征、IHC和EBER原位杂交表达。比较分析单纯细胞涂片、细胞涂片联合CB切片、细胞涂片联合CB切片及IHC和EBER原位杂交3种不同方式对鼻咽癌头颈部淋巴结转移病灶的诊断准确率。结果 1所有病例的细胞涂片及CB切片均显示为非角化性癌的形态学特征。2CB切片IHC和EBER原位杂交显示:肿瘤细胞CK5/6、p63、Ki-67及EBER均为(+);LCA和CK7均呈(-)。33种不同方式对鼻咽癌头颈部淋巴结转移病灶的诊断准确率比较显示:单纯细胞涂片诊断的敏感度(90.3%,28/31)及确诊率(74.2%,23/31)最低;细胞涂片联合CB切片诊断的敏感度(93.5%,29/31)及确诊率(77.4%,24/31)居中;细胞涂片联合CB切片及IHC和EBER原位杂交诊断的敏感度(96.8%,30/31)及确诊率(96.8%,30/31)最高。结论FNA细胞涂片联合CB切片、IHC及EBER原位杂交的方式,对头颈部淋巴结转移性鼻咽癌的早期诊断、寻找原发灶、治疗以及预后判断具有重要意义。
[Abstract]:Objective to investigate the application of fine needle aspiration (FNA) smear combined with (CB) section, immunohistochemical labeling of (IHC) and EBER in situ hybridization in lymph node metastatic nasopharyngeal carcinoma (NPC). Methods samples were obtained from 31 cases of lymph node metastasis of nasopharyngeal carcinoma (NPC) with friendly fine needle puncture device and 21G injection. Cell morphology and CB histomorphology, expression of IHC and EBER in situ hybridization were observed. The diagnostic accuracy of simple cell smear, cell smear combined with CB section, cell smear combined with CB section and IHC and EBER in situ hybridization were compared and analyzed in the diagnosis of lymph node metastasis in head and neck of nasopharyngeal carcinoma (NPC). Results 1Cell smears and CB sections of all cases showed morphological features of non-keratinizing carcinoma. 2CB section IHC and EBER in situ hybridization showed that both CK5/6,p63,Ki-67 and EBER of tumor cells were ();. LCA and CK7 showed (-). The accuracy of 33 different methods in the diagnosis of lymph node metastasis of nasopharyngeal carcinoma showed: the sensitivity of simple cell smear (90.3%, 28 / 31) and the definite diagnosis rate (74.2%) of NPC were 90.3%, 28 / 31 and 74.2%, respectively. 23 / 31) the lowest; The sensitivity (93.5%, 29 / 31) and the correct diagnosis rate (77.4%, 24 / 31) of smear combined with CB were in the middle. The sensitivity of smear combined with CB section and in situ hybridization of IHC and EBER was the highest (96.8%, 30 / 31) and the final diagnosis rate (96.8%, 30 / 31) was the highest. Conclusion the method of FNA cell smear combined with CB section, IHC and EBER in situ hybridization is of great significance in the early diagnosis of metastatic nasopharyngeal carcinoma in the head and neck lymph nodes, in search of primary focus, treatment and prognosis judgement.
【作者单位】：首都医科大学附属北京友谊医院病理科;首都医科大学良乡教学医院病理科;
【分类号】：R739.63

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