淋巴结针吸细胞病理学对淋巴结肿大疾病诊断研究应用_医学论文.docVIP

淋巴结针吸细胞病理学对淋巴结肿大疾病诊断研究应用_医学论文 淋巴结针吸细胞病理学对淋巴结肿大疾病诊断研究应用_医学论文 作者：余占明，佟凤芝，阎妍，王永才，李晓兰，王寰，赵成艳 【摘要】 目的 探讨淋巴结肿大病因，提高淋巴结肿大准确诊断水平。方法 利用改良一次性5～10ml注射器(22G、7号注射器，外径＜0.7mm)，针吸取材、涂片、行改良瑞-姬双染技术，低倍镜查找特殊异常细胞，油镜仔细观察细胞形态结构特征，对于未见异常细胞要进行分类检查，对疑难标本，同时做结核抗体、抗酸菌染色、流式细胞仪、CD系列、基因、DNA异倍体、锌原卟啉(ZPP)、肿瘤标志物等检测指标。结果 结核性淋巴腺炎发病率最高，有546例(36.0%)，结核结节期为主，252例(46.2%)，淋巴结节期184例(33.7%)，其中早期结核性淋巴腺炎233例(44.7%)，转移癌次之有430例(28.3%)，其中以未分化癌为主，156例(32.3%)，腺癌132例(30.7%)，鳞癌114例(26.3%)，而慢性淋巴腺炎352例，占第三位，非霍奇金淋巴瘤98例(6.5%)，以B淋巴细胞型为主70例(71.4%)，T淋巴细胞型17例(17.3%)，NK细胞型11例(11.3%)，其中肿瘤较少见。结论 淋巴结针吸细胞病理学可做淋巴结肿大疾病早期诊断及鉴别诊断，并与预后转归密切相关，而且具有简单快速、经济实用、准确率高、便于推广等优点。 【关键词】 淋巴结针吸；细胞学；淋巴结；早期诊断；价值 【Abstract】 Objective To research lymph node swelling’s reasons and to improve the correct diagnosis level of lymph node swelling.Methods We use remedied disposable injector(5～10volume，22G，outer diameter ＜0.7mm) to materials smear，and dyed the smear with improved Wright-Giemsa Method.Particular abnormal cells were searched under low-multiplying microscope and cell’s structure characteristics were observed carefully under oil lens.Classification examination was put into practice for only normal cells observed.For the dubious specimen，tuberculosis-Ab，acid-fast bacteria staining，flow cytometry，CD series，gene，DNA aneuploidy，ZPP and tumor markers etc were detected.Results Tuberculosis lymph gland inflammation coverd highest rate：546 cases (36%) in which tuberculosis node was 252 cases (46.2%)，lymphonode period was 184 cases (33.7%)，early tuberculosis lymphagland inflammation was 233 cases (44.7%).Metastasis cancer followed it：430 cases (28.3%) in which undivided cancer was 156 cases (32.3%)，glandular cancer 132 cases (30.7%)，epithelial cancer 114 cases (26.3%)， chronic lymph glandular inflammation was 352 cases，Non-Hodgkin’s lymph-tumor 98 cases (6.5%) in which B lymphocyte type covered 70 cases (71.4%)，T lymphocyte covered 17 cases (17.3%)，NK cells type covered 11 cases (11.3%) tumor were sacrce.Conclusion Lymph node needle aspiration patholo