摘要: |
目的 探讨超声引导下细针穿刺细胞蜡块免疫组化及基因检测对于老年患者肺癌锁骨上淋巴结转移的临床应用价值。方法 收集2014年1月至2016年4月我院收治的肺癌锁骨上淋巴结转移患者85例。采用超声引导下细针穿刺,所获得标本行细胞学涂片检查,同时制作成细胞蜡块行免疫组织化学和基因检测。结合随访结果,对单纯细胞学涂片检查与细胞蜡块免疫组化联合应用的诊断进行回顾性分析及对比。结果 本研究中85例患者平均年龄为62.68岁,共穿刺95个淋巴结,穿刺取材成功率为97.9%(93/95),其中21个淋巴结阴性。单纯细胞学形态基础上肺癌组织学正确分类比例为37.3%(25/67),在联合细胞蜡块免疫组化的基础上,其组织学正确分类比例为59.1%(55/93),两者间具有显著差异性。37例肺腺癌细胞蜡块样本中22例行EGFR基因突变检测,16例突变阳性,突变率为72.7%。结论 超声引导下细针穿刺联合细胞蜡块免疫组化诊断肺癌锁骨上淋巴结转移简单实用,可提高临床诊断符合率,并且为肺癌个体化治疗提供了依据。 |
关键词: 超声 肺癌 锁骨上淋巴结 细胞蜡块 组织学 分子病理学 |
DOI: |
投稿时间:2016-06-30修订日期:2016-08-10 |
基金项目: |
|
Research of ultrasound-guided fine-needle aspiration cell blocks immunohistochemistry and gene detection of metastatic supraclavicular lymph nodes in lung cancer |
tianhaiying,xudong |
(Zhejiang Chinese Medical University) |
Abstract: |
Objective To investigate the clinical value of ultrasound-guided fine-needle aspiration cell block immunohistochemical and gene testing for the elderly patients with supraclavicular lymph node metastasis of lung cancer. Methods From January 2014 to April 2016, we have collected 85 patients with supraclavicular lymph node metastasis of lung cancer. Using ultrasound-guided fine-needle aspiration, the specimens were obtained cytological smears, and also made into cell block for immunohistochemical and genetic testing. Combined with follow-up results, the diagnosis of cytological smears and cell block immunohistochemical were retrospectively analyzed and compared. Results In this study, 85 cases of patients and a total of 95 lymph nodes puncture with an average age of 62.68 years, , puncture success rate was 97.9%(93/95), including 21 lymph nodes negative. The lung cancer histological correct classification rate was 37.3%(25/67)under cytology, combined with cell block immunohistochemical, the histological correct classification rate was 59.1%(55/93), between the two have significant differences. 37 cases of lung adenocarcinoma cell block samples in 22 cases of EGFR gene mutation detection, 16 cases of mutation positive, the mutation rate was 72.7%. Conclusions The diagnosis of supraclavicular lymph node metastasis of lung cancer is simple and practical under the ultrasound-guided fine-needle aspiration combined with cell block immunohistochemical. It also can improve the clinical diagnosis rate and provides a basis for individualized treatment of lung cancer. |
Key words: Ultrasound Lung cancer Supraclavicular lymph node Cell block Histology Molecular pathology |