液基薄层细胞学与传统涂片在鼻咽癌筛查中的诊断效能对比研究

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Acomparativestudy of the diagnosticeficacy of ThinPrep cytology and traditional smearsin nasopharyngeal cancer screening Guo Birong"，Yang Kun, Yang Daping， Song Jianhua. *Departmentof Pathology,Guigang , 53710o，China

【Abstract】ObjectiveTo evaluate the utility of ThinPrep cytology (TCT） in nasopharyngeal carcinoma screening.MethodsNasal pharyngeal swabs were colected from1OOpatientswith suspectednasopharyngeal lesions.Both conventional smearsand TCT preparations were prepared.With histopathological diagnosis served as thegoldstandard,two external pathologists conducted double-blindreevaluationof specimenquality,the follwing parameters were compared between the two methods:specimen quality，stainingquality rate,diagnostic performance (sesitivity，specificity，accuracy，positive predictivevalue,negative predictive value,Kappavalue),andslide review time.Intraclass correlation coeffcients(ICC)and superiority testswere used tovalidate staining score objectivityand statistical eficacy.ResultsComparedtoconventional smears，TCT slides exhibited cleaner backgroundswithfewerbloodcelsanddebris，significantly increased diagnosticcell countswithconcentrated distribution,andunilayeredcellarrangementenhancingvisual three-dimensionality，clearlyrevealingnuclear pleomorphism and irregular nuclear membranes.Theexcellent staining rate for TCT was significantly higher than that for conventional smears (91.0% vs 76.0% ， P0.05).External expert review yielded an ICC of0.85.Superiority testing confirmed TCT's superiority over conventional smears in staining qualityrate [difference( 95%CI) was 15%(11.2% ， 18.8% ],with statistical power reaching O.92.Additionally，TCT significantly reduced slide review time ( P

【Key words】Nasopharyngeal carcinoma;Early detection of cancer; Cytological technique；Diagnostic effi

鼻咽癌是指发生在鼻咽腔顶壁和侧壁的恶性肿瘤，已逐渐成为耳鼻咽喉头颈外科的主要恶性肿瘤之一。（剩余10937字）