Hydrothorax And Paraffin-embedded Testing And Two-way Combination Of Traditional Chinese Medicine Treatment Of Malignant Pleural Effusions

Objective (1) To compared the difference of the paraffin imbedding, theThinPrep cytology test (TCT), the cell centrifugalization smear method, the directsmear method in the differential diagnosis Benign and malignant pleuraleffusion or ascites and provide better guidance for us (2) Improving theparaffin imbedding methods to improve its positive rate in diagnosis ofMalignant Pleural Effusion, To provide a basis for the clinical diagnosis; (3)To observe Astragalus and other Chinese herbal medicine joint chest,intravenous chemotherapy with single-channel chemotherapy for malignant pleuraleffusion of the efficacy of treatment toxicity differences, understand the clinical valueof. AN₂O₃ and Chinese herbal medicine in malignant pleural effusion andChinese medicine treatment attenuated.Methods (1)Use the the paraffin imbedding,the ThinPrep cytology test(TCT),thecell centrifugalization smear method and the direct smear method inthe same patients to do cytological examination; (2)For hydrothorax and ascitespatients to do imaging findings, bronchoscopy/surgical and histopathologicexamination of serum tumor markers, hydrothorax and ascites carcinoembryonic antigendetection, and for follow-up treatment, according to WHO for integrated diagnosis; andto compare the fourspeciescytological results with them,to understand fourmethods of cytology positive rate and the rate of clinical diagnosis. (3)The patients whohave been diagnosised of malignant pleural effusion were randomly divided into 2groups,Intravenous chemotherapy +AS₂O₃ intrapleural injection of two chemotherapy groupon the basis of this treatment group with herbs, Observation of the two groups right pleuraleffusion treatment and side effects.Results (1) The cells by centrifugal smear less smear cells, the cells spread unevenly.nuclear Pulp contrast unclear;the ThinPrep cytology test (TCT)can do slidebackground clean, bright stained uniform. nucleocytoplasmic clear, cells were concentrated;the paraffin imbedding showed the number of cells, we also canseemoreorganizations and thickness uniformity, structural integrity, bright coloring, a clear contrastto nuclear pulp; (2)The paraffin imbedding, the ThinPrep cytology test (TCT), the cellcentrifugalization smear method,their cancer cells positive rates were 52.1％. 49.3％,5.5％,0％;The paraffin imbedding,the ThinPrep cytology test (TCT) with thecentrifugalization smear method and the direct smear method difference was statisticallysignificant (P＜0.01), The paraffin imbedding and the ThinPrep cytology test (TCT) have no significant difference (P＞0.05); (3) Compared diagnosis of the paraffinimbedding,the ThinPrep cytology test (TCY),the cell centrifugalization smearmethod with clinical diagnosis findings, diagnosis rate of 92.4％,89.4％,40.9％. Theparaffin imbedding and TCT with the cell centrifugalization smea difference wasstatistically significant (P＜01), The paraffin imbedding and TCT have nosignificant difference (P＞0.05). (4) Conventional and biochemical of tests showedthat all of the malignant pleural effusion or ascites effusions, bloody pleural effusion accounted for41.9％Most of lymphocyte predominance, a mixture of mesothelial cells; Some GLU, LDHincreased; (5) Malignant pleural effusion or ascites serum CEA, CA199 tuberculosissignificantly higher than the average group of jiehe and cirrhosis group, Thedifferences were statistically significant (P＜0.01); CEA positive rate of hydrothorax and ascitesis 83.7％.average 35.45ng/ml.with tuberculosis in patients with cirrhosisand jiehecompared the differences were statistically significant (P＜0.01); (6) All patients were followedup more three months, 43 patients with malignant pleural effusion or ascites patients, 28patients died within 1 year. 5 cases of disease progression, with the diagnosis of malignant tumors,2 cases caught by surgical pathology confirmed that the follow-up recovery. (7) Comparedintravenous chemotherapy+AS₂O₃ intrapleural injection of two chemotherapy groupand increase the efficiency of herbal group have no significance statistical differencebetween them (P＞0.05). Toxicity,after treatment, is blood toxicity, gastrointestinal reactions,chest pain and fever. Herbal group were 35.3％less than non-herbal group, the differencebetween the two groups was statistically significant (P＜0.05); two chest pain, feverastrointestinal reaction rate difference was not significant (P＞0.05)Conclusions (1)The paraffin imbedding,the ThinPrep cytology test (TCT),in cellresolution, the positive rate, Clinical diagnosis were significantly higher than the cellcentrifugalization smear method and the direct smear method;So they may beas the primary means of hydrothorax and ascites cytology; The paraffin imbedding havebeen modified can collected more cells and background clear, can be used to identifytypes of cells, as well as cells in the chemical detection laid the foundation; (2) Serum CEA,CA19-9 and CEA of hydrothorax and ascites can be as malignant pleural effusion or ascites forthe diagnosis of one of the indicators,CEA is more sensitive Meanwhile examines it inhydrothorax and ascites and serum, serum CEA have more greater value Especially toadenocarcinoma.(3) In boody pleural effusion or ascites effusions, GLU andlymphocytes increased, LDH increased which can help us in the diagnosis of malignanttumor; (4) Local As₂O₃ intravenous drug with chemotherapy in the treatment oftwo-way Malignant Pleural Effusion efficacy;As₂O₃ local drug may improve thequality of life; herbal combination is also improve clinical efficacy; (5) In the two-waytreatment on the basis of increase for Astragalus-based Chinese herbal medicine treatment, in patients with increased leukocyte count, improve the quality of life of patientsand has demonstrated obvious edge. Suggest herbs such as astragalus can help chemotherapydrugs reinstate and reinforce the foundation, to play a more effective anti-tumor effect, reducedtoxicity.