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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (1): 208-213. doi: 10.19723/j.issn.1671-167X.2026.01.028

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Application of cell transfer technology in pathological diagnosis of micro-volume cell fluid

Ye ZHAO, Xiaoli DIAO, Yan XIONG*()   

  1. Department of Pathology, Peking University First Hospital, Beijing 100034, China
  • Received:2025-07-04 Online:2026-02-18 Published:2026-01-04
  • Contact: Yan XIONG

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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

CLC Number: 

  • R446.8

Figure 1

Micro-volume cell fluid: Cerebrospinal fluid, bronchial washing, bronchoalveolar lavage fluid, thyroid fine-needle aspiration fluid (from left to right)"

Figure 2

The operation process of cell transfer technology A, divide the area and mark the directions; B, remove the cover glass and set it aside for later use, add Mount Quick gel; C, soaking in warm water; D, remove the gel film, place in the same direction as the cover glass; E, cut the gel film and make the marking copy; F, transfer to slides for different staining projects."

Figure 3

The staining images before and after cell transfer A, medullary thyroid carcinoma in fine needle aspiration fluid (A1, before, HE ×10; A2, after, HE ×200; A3, CgA+ + +, ICC ×200; A4, calcitonin+, ICC ×200); B, malignant melanoma in left inguinal lymph nodes fluid (B1, after, HE ×200; B2, HMB45+ +, ICC ×200; B3, malen-A+ +, ICC ×200; B4, S100+ +, ICC ×200); C, pulmonary infection in bronchoalveolar lavage fluid (C1, after, HE ×200; C2, GMS+, specific stain, ×200); D, brain metastasis of lung adenocarcinoma in cerebrospinal fluid (D1, after, HE ×200; D2, TTF-1+ + +, ICC ×200). HE, hematoxyllin-eosin; ICC, immunocytochemistry; CgA, chromogranin A; HMB45, human melanoma black 45; GMS, gomori methenamine silver; TTF-1, thyroid transcription factor-1."

Table 1

Enhancement of diagnostic results by cell transfer technology"

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
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