华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

应用细针穿刺制作细胞块技术诊断腮腺区肿块的临床意义

陈宏1 方庆全2 涂金花2 蔡巧玲3 张素花4   

  1. 1.厦门大学附属第一医院药学部;2.病理科;3.口腔科;4.超声影像科,厦门361003
  • 收稿日期:2016-03-15 修回日期:2016-07-02 出版日期:2016-10-01 发布日期:2016-10-01
  • 通讯作者: 方庆全,主任技师,学士,E-mail:fqq1260@163.com
  • 作者简介:陈宏,主管药师,学士,E-mail:fqqch1999@163.com

Clinical efficacy of the fine needle aspiration of the cell block in the diagnosis of parotid gland masses

Chen Hong1, Fang Qingquan2, Tu Jinhua2, Cai Qiaoling3, Zhang Suhua4.   

  1. 1. Pharmaceutical Department, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China; 2. Dept. of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China; 3. Dept. of Stomatology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China; 4. Supersonic Phantom Branch, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
  • Received:2016-03-15 Revised:2016-07-02 Online:2016-10-01 Published:2016-10-01
  • Contact: Fang Qingquan, E-mail: fqq1260@163.com.

摘要:

目的 探讨超声引导下细针穿刺制作细胞块在诊断腮腺区肿块方面的应用价值。方法在彩色超声仪引导下,对285个腮腺区肿块进行细针穿刺,将穿刺标本制成细胞块,以进行病理学诊断。对非肿瘤性肿块采取保守治疗,囊肿与肿瘤性肿块采取手术治疗。对术后病理确诊为腺样囊性癌(ACC)与多形性腺瘤(PA)对应的细胞块行干细胞因子受体CD117免疫组织化学检测。结果标本制作满意率为95.1%(271/285),诊断准确率为94.5%(256/271);诊断敏感度为87.0%(67/77),特异度为98.1%(157/160)。CD117在ACC中的阳性表达率为95.2%(20/21),在PA中为20.3%(25/123),ACC中阳性表达率明显高于PA,二者差异有统计学意义(P<0.01)。结论超声引导下腮腺区肿块细针穿刺制作细胞块结合分子标志物检测,对腮腺区肿块的诊断具有重要意义。

关键词: 腮腺, 肿块, 细针穿刺, 细胞块, 分子标志物

Abstract:

Objective To investigate the clinical significance of cell blocks obtained by ultrasound-guided fine needle aspiration in diagnosing parotid gland masses. Methods Cell blocks were made in 285 parotid gland masses by ultrasound guided fine needle aspiration. Diagnosis was conducted using the cell blocks. Non-tumor masses were subjected to conservative treatment, and cysts and tumors were treated with surgery. The cell block sections from masses with the diagnosis of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA) were applied to the detection of immunocytochemical staining forthe stem cell factor receptor CD117. Results  The satisfaction rate of the specimen was 95.1% (271/285). The accuracy rate of the diagnosis was 94.5% (256/271), the sensitivity was 87.0% (67/77), and the specificity was 98.1% (157/160). The positive rate of CD117 in ACC was 95.2% (20/21), whereas that in PA was 20.3% (25/123). The positive rate of CD117 in ACC was higher than that in PA (P<0.01). Conclusion  The use of cell blocks obtained from ultrasound-guided fine needle aspiration, together with molecular marker detection, has great significance in diagnosing parotid gland masses.

Key words: parotid gland, mass, fine needle aspiration, cell block, molecular marker