【摘要】：目的探討細(xì)針吸取(FNA)涂片聯(lián)合細(xì)胞塊(CB)切片、免疫組化標(biāo)記(IHC)和EBER原位雜交在淋巴結(jié)轉(zhuǎn)移性鼻咽癌中的應(yīng)用。方法采用友誼式細(xì)針穿刺器和21G注射針對31例鼻咽癌頭頸部淋巴結(jié)轉(zhuǎn)移病灶獲取樣本制片,觀察其細(xì)胞形態(tài)學(xué)及CB組織形態(tài)學(xué)特征、IHC和EBER原位雜交表達(dá)。比較分析單純細(xì)胞涂片、細(xì)胞涂片聯(lián)合CB切片、細(xì)胞涂片聯(lián)合CB切片及IHC和EBER原位雜交3種不同方式對鼻咽癌頭頸部淋巴結(jié)轉(zhuǎn)移病灶的診斷準(zhǔn)確率。結(jié)果 1所有病例的細(xì)胞涂片及CB切片均顯示為非角化性癌的形態(tài)學(xué)特征。2CB切片IHC和EBER原位雜交顯示:腫瘤細(xì)胞CK5/6、p63、Ki-67及EBER均為(+);LCA和CK7均呈(-)。33種不同方式對鼻咽癌頭頸部淋巴結(jié)轉(zhuǎn)移病灶的診斷準(zhǔn)確率比較顯示:單純細(xì)胞涂片診斷的敏感度(90.3%,28/31)及確診率(74.2%,23/31)最低;細(xì)胞涂片聯(lián)合CB切片診斷的敏感度(93.5%,29/31)及確診率(77.4%,24/31)居中;細(xì)胞涂片聯(lián)合CB切片及IHC和EBER原位雜交診斷的敏感度(96.8%,30/31)及確診率(96.8%,30/31)最高。結(jié)論FNA細(xì)胞涂片聯(lián)合CB切片、IHC及EBER原位雜交的方式,對頭頸部淋巴結(jié)轉(zhuǎn)移性鼻咽癌的早期診斷、尋找原發(fā)灶、治療以及預(yù)后判斷具有重要意義。
[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.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院病理科;首都醫(yī)科大學(xué)良鄉(xiāng)教學(xué)醫(yī)院病理科;
【分類號】：R739.63

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