细胞转移技术在微量细胞液病理诊断中的应用

doi:10.19723/j.issn.1671-167X.2026.01.028

摘要/Abstract

摘要：

目的: 探讨细胞转移技术应用于微量细胞液病理诊断的技术关键点及价值。方法: 收集北京大学第一医院病理科2024年9月至2025年6月, 细胞学诊断为肿瘤细胞或非典型性细胞的微量细胞液样本, 共32例, 提取薄层液基细胞学技术(ThinPrep cytology test, TCT)制作的切片, 将切片上的细胞膜分割后分别转移到相应的载玻片上, 进行免疫细胞化学(immunocytochemistry, ICC)及特殊染色。对比转移前后苏木精-伊红(hematoxylin-eosin, HE)染色片, 评估细胞转移技术在维持细胞形态前后一致性方面的表现。对细胞转移后的ICC和特殊染色结果再次诊断, 评估细胞转移技术对提升鉴别诊断准确率的价值。结果: 32例样本共转移140张转移片, 其中HE染色片32张, 无论是染色质量还是细胞形态和排列方式均与原始TCT制片一致, 成功率100%;ICC染色片99张, 其中91张着色定位准确、背景清晰, 成功率91.91%;特殊染色片9张, 色彩对比鲜明, 背景清晰, 成功率100%。借助细胞转移后的ICC和特殊染色结果, 32例样本中26例明确诊断, 包括恶性肿瘤18例和非肿瘤性病变8例, 另6例仍无法确诊, 其中4例ICC染色失败, 2例细胞量过少。与细胞转移前相比, 鉴别诊断准确率提高到81.25%(26/32)。结论: 将细胞转移技术应用于TCT制片在临床实践中具有可行性, 适用于需要ICC及特殊染色辅助诊断的病例。该技术可提高微量细胞液样本鉴别诊断的准确率, 在无法获得组织学样本或只能依靠微量细胞液样本的病理诊断决定治疗策略时, 具有重要的临床价值。

关键词: 细胞诊断学, 标本制备, 免疫组织化学, 细胞转移技术, 微量细胞液

Abstract:

Objective: To explore the key technical points and value of cell transfer technology in the diagnosis of micro-volume cell fluid. Methods: In the study, 32 micro-volume cell fluid samples with the diagnosis of tumor or atypical cells in the Department of Pathology, Peking University First Hospital were collected from September 2024 to June 2025. The cells on the ThinPrep cytology test (TCT) slides were divided into several sections and transferred to corresponding slides for immunocytochemistry (ICC) and special staining. Hematoxylin-eosin (HE) staining slides before and after transfer were compared to evaluate the performance of cell transfer technology in maintaining the consistency of cell morphology. The re-diagnosis referring to the results of ICC and special staining of transfer slides were made. The diagnosis before and after cell transfer was compared to evaluate the value of technology in improving the differential diagnostic accuracy. Results: A total of 140 cell transfer slides were prepared from the 32 samples. Among them, 32 HE-stained slides were consistent with the original TCT slides in terms of staining quality, cell morphology and arrangement, with a success rate of 100%; 99 transfer slides were immuno-stained, of which 91 had accurate color and position of positivity and clear background of negativity, with a success rate of 91.91%; 9 special-stained slides had sharp color contrast and clear background, with a success rate of 100%. With the help of ICC and special staining results of transfer slides, 26 of the 32 samples were accurately diagnosed, including 18 cases of malignant tumors and 8 cases of non-neoplastic lesions; 6 cases remained undiagnosed, including four due to ICC staining failure and two due to too few cells. Compared with the original cytological diagnosis, a definitive differential diagnosis was obtained in 81.25% of cases after cell transfer. Conclusion: The application of cell transfer technology in TCT samples is feasible in clinical practice and is suitable for cases requiring ICC and special staining for auxiliary diagnosis. It can significantly improve the differential diagnostic accuracy for the micro-volume cell fluid samples, which is invaluable for the special cases which pathological diagnosis can only be made based on the micro-volume cell fluid samples because no more tissue sample is available.

Key words: Cytodiagnosis, Specimen handling, Immunohistochemistry, Cell-transfer technique, Micro-volume cell fluid

中图分类号:

R446.8

赵业, 刁小莉, 熊焰. 细胞转移技术在微量细胞液病理诊断中的应用[J]. 北京大学学报（医学版）, 2026, 58(1): 208-213.

Ye ZHAO, Xiaoli DIAO, Yan XIONG. Application of cell transfer technology in pathological diagnosis of micro-volume cell fluid[J]. Journal of Peking University (Health Sciences), 2026, 58(1): 208-213.

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参考文献 9

1	李春海, 李克勤. 肿瘤微血管生成的机制与肿瘤侵袭和转移[J]. 中华肿瘤杂志, 2000, 22 (3): 181- 183.
2	潘秦镜, 李凌, 张询, 等. 液基细胞学筛查宫颈癌的研究[J]. 中华肿瘤杂志, 2001, 23 (4): 309- 312.
3	Miller RT . Avoiding pitfalls in diagnostic immunohistochemistry: Important technical aspects that every pathologist should know[J]. Semin Diagn Pathol, 2019, 36 (5): 312- 335. doi: 10.1053/j.semdp.2019.05.002
4	Wen CH , Lin CH , Ko PL , et al. Cell transfer technique for constructing cytological microarrays for immunocytochemical analysis[J]. Cytopathology, 2017, 28 (2): 157- 163. doi: 10.1111/cyt.12360
5	王一凡, 张兰兰, 杨巧, 等. 2种免疫细胞化学染色方法在脑脊液转移性肺腺癌诊断中的应用[J]. 广西医科大学学报, 2024, 41 (8): 1171- 1175.
6	崔娣, 陈争先, 刘龙腾, 等. 细胞转移技术在细针穿刺细胞学诊断中的应用[J]. 中华病理学杂志, 2021, 50 (6): 615- 619.
7	Gong Y , Joseph T , Sneige N . Validation of commonly used immunostains on cell-transferred cytologic specimens[J]. Cancer, 2005, 105 (3): 158- 164. doi: 10.1002/cncr.21063
8	Jimenez-Joseph D , Gangi MD . Application of Diatex compound in cytology: Use in preparing multiple slides from a single routine smear[J]. Acta Cytol, 1986, 30 (4): 446- 447.
9	石远凯, 孙燕, 于金明, 等. 中国肺癌脑转移诊治专家共识(2017年版)[J]. 中国肺癌杂志, 2017, 20 (1): 1- 12.

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Diagnostic results before cell transfer	Diagnostic results after cell transfer	Sample	n	Marker
Consider tumor cells; Individual epithelial cells with atypia	Adenocarcinoma of lung	CSF, BALF	9	CKPan (AE1/AE3), TTF-1, Pax-8, TFE3, p40
A large number of cell nuclei with irregular shapes	T-cell lymphoblastic lymphoma	CSF	2	TdT, CD34, CD68, CKPan (AE1/AE3), CD3, CD20, Olig2, GFAP, Ki67
Malignant cell	Malignant melanoma	Left inguinal lymph node FNA fluid	1	CKPan (AE1/AE3), S-100, LCA/CD45, vimentin, HMB45, melan-A
Scattered atypical cells are distributed, and the nucleoli can be seen	Cardia cancer	CSF	1	CEA, CKPan (AE1/AE3), LCA/CD45
There are a large number of small lymphocytes and monocytes, as well as atypical cells with large nuclei and immature morphology	B lymphoblastic leukemia	CSF	2	TdT, Pax-5
Clustered atypical glandular cells, with mucous present in the cytoplasm and prominent nucleoli	Endometrial cancer	Peritoneal wash	1	Pax-8
A large number of mycelia were detected	Pneumocystis pneumonia; Pulmonary infection	Ebus needle aspiration fluid, BALF	2	GMS, PAS, AFB, WAFB
Malignant cell	Adenocarcinoma of stomach	Ascites (a little)	1	TTF-1, Pax-8, WT1, CK7, CK20, CDX-2
Consider cells with unclear pathological significance that exhibit atypical changes (TBSRTC Ⅲ)	Medullary thyroid carcinoma	Thyroid FNA fluid	1	Congo red, calcitonin, Syn, CgA
Cells are scattered and distributed in clusters, with enlarged nuclei and an increased nuclear-cytoplasmic ratio; Some epithelial cells show atypia	Non-tumoral lesion	BALF, bronchial washing, CSF	8	GATA3, CEA, Ki67, TdT, CD34, CD20, CD117, MPO, CD68, TTF-1, SALL-4, Syn, CD1a, Olig2