The rapid pathological diagnostic value of cytological smear in pulmonary nodule during operation

doi:10.11958/20240093

Abstract

Abstract:

Objective To explore the rapid pathological diagnostic value of cytological smear in pulmonary nodule during surgery. Methods A total of 40 lung nodule specimens collected during thoracoscopic surgery were performed cytological smears, Diff rapid staining was used to observe under light microscopy. Real-time report was given results. The results of intraoperative frozen section and postoperative paraffin section were compared. The result of postoperative paraffin section was used as the gold standard for the diagnosis. Results of cytological smear and frozen section diagnosis were divided into the confirmed, misdiagnosed and delayed diagnose groups. The diagnostic accuracy was calculated. Results In 40 lung nodule specimens, 28 cases were diagnosed with adenocarcinoma, 2 cases were diagnosed with squamous cell carcinoma, 1 case with pulmonary hamartoma, 1 case with sclerosing pneumocytoma, 3 cases with granulomatous lesions and 5 cases with organizing or inflammatory lesions by paraffin sections. Thirty-eight cases were diagnosed by cytological smears, with an accuracy rate of 95.0%. One case was misdiagnosed and one case was delayed in diagnosis. Thirty-nine cases were diagnosed by frozen sections, with an accuracy rate of 97.5%, and 1 case was delayed in diagnosis. There was no significant difference in the diagnostic accuracy between cytological smear and frozen section examination for intraoperative pulmonary nodules (χ²=0.000，P=1.000). Conclusion Cytological smear examination has high accuracy in rapid pathological diagnosis of pulmonary nodules during surgery and has clinical practical value.

Key words: histocytological preparation techniques, frozen sections, pulmonary nodule, rapid intraoperative pathological diagnosis, cytological smear

CLC Number:

R446.9

Figures/Tables 7

Tab.1 Diagnosis results of cytological smears and frozen sections in 40 cases of pulmonary nodules

石蜡切片诊断	n	细胞学涂片诊断			冷冻切片诊断
石蜡切片诊断	n	确诊	误诊	延迟诊断	确诊	误诊	延迟诊断
腺癌	28	27	0	1	27	0	1
鳞癌	2	2	0	0	2	0	0
肺错构瘤	1	1	0	0	1	0	0
硬化性肺细胞瘤	1	0	1	0	1	0	0
肉芽肿病变	3	3	0	0	3	0	0
机化性病变或炎性病变	5	5	0	0	5	0	0
合计	40	38	1	1	39	0	1

Fig.1 Cytological characteristics of adenocarcinoma （Diff-Quik stain）

Fig.2 Cytological characteristics of squamous cell carcinoma (Diff-Quik stain, ×1 000)

Fig.3 Cytological characteristics of pulmonary hamartoma (Diff-Quik stain)

Fig.4 Cytological characteristics of pulmonary sclerosing pneumocytoma (Diff-Quik stain, ×1 000)

Fig.5 Cytological characteristics of tuberculosis and cryptococcal infection (Diff-Quik stain, ×1 000)

Fig.6 Cytological characteristics of organizing lesions (Diff-Quik stain, ×1 000)

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