tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027//2224-5057-2017-7-4-13-20tumors-434Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSИСПОЛЬЗОВАНИЕ ЦИТОЛОГИЧЕСКОГО МАТЕРИАЛА ПРИ ДИАГНОСТИКЕ РАКА ЛЕГКОГОTHE USAGE OF CYTOLOGICAL MATERIAL FOR DIAGNOSTICS OF LUNG CANCERГригорукО. Г.GrigorukO. G.

Ольга Г. Григорук - доктор биологических наук, старший научный сотрудник АФ НМИЦ онкологии им. Н.Н. Блохина, зав. отделением клинической лабораторной диагностики (для проведения цитологических методов исследования) АКОД, доцент кафедры общей и биохимической химии, клинической лабораторной диагностики АГМУ.

Барнаул

Olga G. Grigoruk - MD, DSc, Senior Researcher AB of N.N. Blokhin RCRC; Head of the Department of Clinical Laboratory Diagnostics (for carrying out cytological methods of research) AROC; Associate Professor of the Department of General and Biochemical Chemistry, Clinical Laboratory Diagnostics AS MU.

Barnaul

cytolakod@rambler.ruПупковаЕ. Э.PupkovaE. I.

Елена Э. Пупкова - заведующая отделением клинической лабораторной диагностики (лаборатория молекулярной диагностики).

Elena I. Pupkova - MD, Head of the Department of Clinical Laboratory Diagnostics (Laboratory of Molecular Diagnostics).

elenapupkova@yandex.ruБазулинаЛ. М.BazulinaL. M.

Лариса М. Базулина - врач-цитолог отделения клинической лабораторной диагностики (для проведения цитологических методов исследования).

Larisa M. Bazulina - MD, Department of Clinical Laboratory Diagnostics (for carrying out cytological methods of research).

lardok69@mail.ruЛазаревА. Ф.LazarevA. F.

Александр Ф. Лазарев – доктор медицинских наук профессор, директор АФ НМИЦ онкологии им. Н.Н. Блохина, главный врач АКОД, зав. кафедрой онкологии и лучевой терапии и лучевой диагностики с курсом ДПО АГМУ.

Alersandr F. Lazarev - MD, DSc Med, Professor, Director of AB of N.N. Blokhin RCRC; Chief Physician AROC; Head of the Department of Oncology and Radiation Therapy and Radiation Diagnostics ASMU.

Barnaul

aoc@ab.ruАлтайский филиал ФГБУ «НМИЦ онкологии им. Н. Н. Блохина» Минздрава России; КГБУЗ «Алтайский краевой онкологический диспансер»; ФГБОУ «Алтайский государственный медицинский университет» Минздрава РоссииРоссияAltai branch of N. N. Blokhin Russian Cancer Research Center; Altai Regional Oncology Center; Altai State Medical University.Russian FederationКГБУЗ «Алтайский краевой онкологический диспансер»РоссияAltai Regional Oncology Center.Russian FederationАлтайский филиал ФГБУ «НМИЦ онкологии им. Н. Н. Блохина» Минздрава России; КГБУЗ «Алтайский краевой онкологический диспансер»; ФГБОУ «Алтайский государственный медицинский университет» Минздрава РоссииРоссияAltai branch of N. N. Blokhin Russian Cancer Research Center; Altai Regional Oncology Center; Altai State Medical UniversityRussian Federation201718012018741320Copyright © Григорук О.Г., Пупкова Е.Э., Базулина Л.М., Лазарев А.Ф., 20182018Григорук О.Г., Пупкова Е.Э., Базулина Л.М., Лазарев А.Ф.Grigoruk O.G., Pupkova E.I., Bazulina L.M., Lazarev A.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/434

В статье показаны возможности использования цитологического материала при диагностике рака легкого на примере работы онкологического диспансера в течение одного года. Световая микроскопия использована при изучении цитологических препаратов различного материала у 729 больных. Метод позволил установить диагноз рака легкого в большинстве наблюдений с определением гистологического типа в 89%. При сопоставлении цитологического заключения с окончательным диагнозом расхождения в определении гистотипа опухоли составляют менее 1%. Иммуноцитохимические исследования использованы при исследовании плевральных жидкостей у 40 пациентов без установленного первичного очага. Иммуноцитохимические исследования позволили уточнить принадлежность клеток опухоли к метастазу из легкого, повысить точность диагностики до 96%. Цитологический материал 62 пациентов, полученный при бронхоскопическом исследовании, пункций лимфатических узлов, плевральной жидкости и мокроты с наличием достаточного количества клеток опухоли (не менее 200) является полноценным материалом для молекулярно-генетических исследований. Использование цитологического материала для поиска соматических мутаций оправдано для онкологических пациентов с местнораспространенным или диссеминированным процессом, у которых цитологический материал является единственно доступным морфологическим материалом для исследования.

The article shows the possibilities of the usage of cytological material for diagnostics of lung cancer at the example of work of an oncological outpatient clinic during one year. Light microscopy was used to study of cytological specimens of various material of 721 patients. The method has allowed to determine the diagnosis of lung cancer in majority of the observed cases with definition of histological type in 89%. When comparing the results of cytology with the final diagnosis the difference of determination of the tumor histological types is less than 1%. The immunocytochemical test is used at the examination of pleural fluid of 40 patients without determined primary locus. The immunocytochemical research has allowed specifying the inhering of the tumor cells to the metastasis from the lung, elevating the precision of the diagnostics to 96%. The cytological material of 62 patients obtained during the bronchoscopic examination, puncture of lymphatic nodules, pleural fluid and sputum with presence of a sufficient quantity of tumor cells (not less than 200) represents appropriate material for molecular-genetic research. The usage of cytological material for search of somatic mutations is justified for oncological patients with locally advanced or disseminated process, whose cytological material is the unique accessible morphological material for research.

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The authors declare that there are no conflicts of interest present.