Weir M M, Rosenberg A E, Bell D A
Department of Pathology, Massachusetts General Hospital, Boston 02114, USA.
Am J Clin Pathol. 1999 Dec;112(6):784-90. doi: 10.1093/ajcp/112.6.784.
We studied whether histologic criteria for grading sarcomas could be applied to fine-needle aspiration biopsy (FNAB) specimens of adult spindle cell sarcomas, without knowledge of the sarcoma subtype, by reviewing 36 specimens. Grade 1 was assigned for minimal nuclear atypia and overlap, no necrosis, and rare mitotic figures, and grade 2 for moderate nuclear atypia, at least moderate nuclear overlap, appreciable mitotic figures, and necrosis. Severe nuclear atypia distinguished grade 3 from grade 2. A major noncorrelation between FNAB and histologic grades was defined as a misclassification of grade 1 vs grade 2 or 3. FNAB grades assigned were grade 1, 1; grade 2, 25; and grade 3, 10. There was 1 major noncorrelation due to a probable FNAB interpretation error. In 15 of 16 FNAB specimens of grade 2 or 3 sarcomas lacking mitotic figures, necrosis, or both, the nuclear atypia reflected the grade. In the remaining case, the degree of nuclear overlap and necrosis determined the grade. The histologic grading of sarcomas can be applied accurately to most FNAB specimens of spindle cell sarcomas without knowledge of the sarcoma subtype.
我们通过回顾36份标本，研究了在不了解肉瘤亚型的情况下，肉瘤分级的组织学标准是否可应用于成人梭形细胞肉瘤的细针穿刺活检（FNAB）标本。对于核异型性和核重叠轻微、无坏死且有罕见核分裂象的标本判定为1级，对于核异型性中等、至少有中等程度核重叠、有明显核分裂象且有坏死的标本判定为2级。严重核异型性将3级与2级区分开来。FNAB分级与组织学分级之间的主要不相关性定义为1级与2级或3级的错误分类。所分配的FNAB分级为：1级，2例；2级，25例；3级，10例。由于可能的FNAB解读错误，存在1例主要不相关性。在16份2级或3级肉瘤的FNAB标本中，有15份缺乏核分裂象、坏死或两者皆无，其核异型性反映了分级。在其余病例中，核重叠程度和坏死情况决定了分级。在不了解肉瘤亚型的情况下，肉瘤的组织学分级可准确应用于大多数梭形细胞肉瘤的FNAB标本。
