Clinical Value Of Cell-block In Diagnostic Benign And Malignant Pleural And Peritoneal Effusion

Objective: Find a cytopreparation technology to improve the positivedetection rates in cytopathology in comparison with ordinary smear and cellblock in diagnostic benign and malignant pleural and peritoneal effusion.Methods: The samples collected from June2013to November2013during the First Hospital of Jilin University, and eventually confirm thediagnosis of200cases of patients with pleural effusion or peritoneal effusionspecimens, including139cases of pleural effusion and61cases of peritonealeffusion. We prepared one cell block and one smear, morphological diagnosisby microscope. The result of malignant effusion is: using cytology microscopeto find the tumor cells. These results are using SPSS19.0software for statisticalanalysis.Result:1. The positive detection rates of the two kinds of cytopreparationtechnology: In200cases of pleural and peritoneal effusion,57cases of cellblock was positive, the positive detection rate was28.5%,44cases of smearwas positive, the positive detection rate was22.0%. The positive detection rateof cell block was higher than smear, the differences was statistically significant(p <0.05). 2. Histological types of malignant pleural and peritoneal effusiondiagnosis by cytopathology:59cases of malignant pleural and peritonealeffusion included49cases of adenocarcinoma,3cases of squamous cellcarcinoma,2cases of small cell carcinoma,1case of malignant lymphoma and4cases which could not be typed. In200cases of pleural and peritonealeffusion,49cases of cell block was adenocarcinoma, the positive detection ratewas32.5%,44cases of smear was adenocarcinoma, the positive detection ratewas20.5%. The positive detection rate of ADA of cell block was higher thansmear, the differences was statistically significant (p <0.05). There is nodifferent between cell block and smears in the number of squamous cellcarcinoma, small cell carcinoma, malignant lymphoma and the cases whichcould not be typed.3. The relationship between characters of specimens and cytopathologydiagnosis results: In200cases of pleural and peritoneal effusion,78cases ofbloody effusion (32of these cases was malignant),141cases of non-bloodyeffusion (27of these cases was malignant), the differences was statisticallysignificant (p <0.05).Conclusion:1. The positive detection rate of cell block (28.5%) was higher than smear(22.0%). cell block is a better cytopreparation technology than smear, which isworth to spread. 2. Histological typing by cytopathology could have clinical significance tothe treatment plan, including adenocarcinoma, squamous cell carcinoma, andsmall cell carcinoma. The positive detection rate of adenocarcinoma by cellblock (28.5%) was higher than smear (22.0%), because tissue structure couldbe seen by microscope, especially adenoid structure. Cell block is more usefulfor histological typing, and it is significant for diagnosis and treatment.3. The characters of specimens is associated with the positive rate, bloodeffusion is more possible to be malignant. In order to obtain clear background,blood specimens should be mixes with50%ethanol before smeared orsectioned, which could improve the accuracy of diagnosis of cytopathology.