使用生物孔膜的印迹细胞学诊断眼表鳞状上皮肿瘤的可靠性
Reliability of impression cytology for the diagnosis of ocular surface squamous neoplasia employing the Biopore membrane.
作者信息
Tole D M, McKelvie P A, Daniell M
机构信息
Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
出版信息
Br J Ophthalmol. 2001 Feb;85(2):154-8. doi: 10.1136/bjo.85.2.154.
AIM
To evaluate the accuracy of impression cytology employing a Biopore membrane device in the diagnosis of ocular surface squamous neoplasia (OSSN).
METHODS
The histology of patients undergoing excision biopsy for the suspected diagnosis of OSSN over a 20 month period was compared with the reported cytology of impression cytology specimens obtained preoperatively using the Biopore membrane device.
RESULTS
25 excision biopsies were performed for suspected OSSN. There was accurate correlation in 20 out of the 25 cases (80%). In three cases (12%), there was poor correlation in that only a few dysplastic cells and hyperkeratosis were noted on cytology, whereas histology showed keratinising dysplasia in two cases and a moderately differentiated keratinising squamous cell carcinoma in the third. There were two cases (8%) of non-correlation--one keratinising dysplasia on histology, but anucleate keratin, squamous metaplasia, and rare atypical cells on cytology, and another case with very mild focal dysplasia on histology but squamous metaplasia on cytology. Review of the cytology showed that dysplastic cells were either rare or absent from the cytology specimens in these two cases; it was felt that these represented sampling problems rather than true false negatives. There were no false positives on cytology. Final diagnosis on histology was squamous cell carcinoma in one; carcinoma in situ in two; keratinising dysplasia in 15, non-keratinising dysplasia in seven.
CONCLUSION
Impression cytology employing the Biopore membrane accurately predicts the histological diagnosis of OSSN. The presence of hyperkeratosis, inflammatory cells with only a few dysplastic cells, may indicate high grade keratinising dysplasia or squamous cell carcinoma. The method is both rapid and easy to perform in routine clinical practice. These findings suggest that there may be a role for its use in the initial assessment and follow up of patients with suspected OSSN.
目的
评估使用生物孔膜装置的印片细胞学检查在眼表鳞状上皮肿瘤（OSSN）诊断中的准确性。
方法
将20个月期间因疑似OSSN接受切除活检患者的组织学检查结果，与术前使用生物孔膜装置获取的印片细胞学标本的报告细胞学结果进行比较。
结果
对疑似OSSN进行了25例切除活检。25例中有20例（80%）存在准确的相关性。3例（12%）相关性较差，即细胞学检查仅发现少数发育异常细胞和角化过度，而组织学检查显示2例为角化性发育异常，第3例为中度分化的角化性鳞状细胞癌。有2例（8%）不相关——1例组织学为角化性发育异常，但细胞学为无核角化、鳞状化生和罕见的非典型细胞；另一例组织学为非常轻微的局灶性发育异常，但细胞学为鳞状化生。对细胞学检查结果的复查显示，这2例细胞学标本中发育异常细胞罕见或不存在；认为这些代表取样问题而非真正的假阴性。细胞学检查无假阳性。组织学最终诊断为1例鳞状细胞癌；2例原位癌；15例角化性发育异常，7例非角化性发育异常。
结论
使用生物孔膜的印片细胞学检查能准确预测OSSN的组织学诊断。存在角化过度、仅有少数发育异常细胞的炎症细胞，可能提示高级别角化性发育异常或鳞状细胞癌。该方法在常规临床实践中既快速又易于操作。这些发现表明，其在疑似OSSN患者的初始评估和随访中可能有应用价值。
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