Lin S M, Kuo S H, Lin D Y, Lin C J, Shen C H, Hung C F
First Department of Diagnostic Radiology, Chang-Gung Memorial Hospital, Taipei, Taiwan.
Acta Cytol. 2000 Jan-Feb;44(1):1-6. doi: 10.1159/000326215.
To illustrate the cytologic features of hepatocellular carcinoma (HCC) after percutaneous acetic acid injection (PAI) and to correlate the cytologic findings with helical computed tomography (CT) findings.
The study included 30 patients with 37 HCC who had undergone PAI. Baseline cytomorphology of HCC was evaluated by needle aspiration in all cases. PAI under ultrasound guidance was done every three to seven days. Upon completion of PAI, fine needle aspiration cytology was performed and followed by helical CT within two weeks. The degeneration of HCC after PAI was classified into two grades. Grade 1 showed incomplete degeneration (99% of nuclear area); grade 2 showed complete degeneration or severe degeneration with cell debris or amorphous material only. The specimens were stained with Riu's method (Romanowsky system).
The cytologic changes after PAI included decreased cell number, reduced cellular aggregation, degeneration of cytoplasm and nucleus, and eosinophilic or basophilic background in all tumors. In all the 37 tumors without enhancement on helical CT, grade 2 degeneration was detected.
Our results reveal that grade 2 degeneration alone, demonstrated cytologically, could indicate almost complete necrosis of HCC after PAI, probably implying no need for booster PAI.
阐述经皮乙酸注射（PAI）后肝细胞癌（HCC）的细胞学特征，并将细胞学检查结果与螺旋计算机断层扫描（CT）结果相关联。
该研究纳入了30例患有37个HCC且接受过PAI的患者。所有病例均通过针吸评估HCC的基线细胞形态。在超声引导下每三至七天进行一次PAI。PAI完成后，进行细针穿刺细胞学检查，并在两周内进行螺旋CT检查。PAI后HCC的退变分为两级。1级表现为不完全退变（核面积的99%）；2级表现为完全退变或严重退变，仅伴有细胞碎片或无定形物质。标本采用瑞氏法（罗曼诺夫斯基染色系统）染色。
PAI后的细胞学变化包括所有肿瘤的细胞数量减少、细胞聚集减少、细胞质和细胞核退变以及嗜酸性或嗜碱性背景。在螺旋CT上无强化的所有37个肿瘤中，均检测到2级退变。
我们的结果表明，仅通过细胞学显示的2级退变可能表明PAI后HCC几乎完全坏死，可能意味着无需追加PAI。
