两种方法对细针穿刺抽吸所得乳腺癌分级的比较评估

Comparative evaluation of grading of breast carcinomas in fine needle aspirates by two methods.

作者信息

Das A K, Kapila Kusum, Dinda A K, Verma Kusum

机构信息

Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

出版信息

Indian J Med Res. 2003 Dec;118:247-50.

PMID:14870798

Abstract

BACKGROUND & OBJECTIVES: Fine needle aspiration (FNA) material is increasingly being used to determine various prognostic parameters in patients with carcinoma breast. It was recommended that cytological grading should be part of all FNA reports of breast carcinoma so that preoperative prognostication could be done on it. However, the most reliable method for cytological grading that closely reflects the most widely used histological grading system is yet to be determined. This study was undertaken to compare results of two cytological grading methods to see which corresponded better to the histological grade.

METHODS

In a double-blind study, cytological grading of 52 patients with breast carcinoma was carried out using two different grading systems (Robinson's and Mouriquand's methods) and the grades compared with the histological grading to find out which reflected histological grades more closely.

RESULTS

By Robinson's method 28.8, 46.2 and 25 per cent aspirates were graded as I, II and III respectively. Using Mouriquand's grading 9.6, 69.2 and 21.2 per cent aspirates were graded correspondingly. Comparison of the two methods showed a concordance in 40 (76.9%) cases. Both cytological grading systems showed a concordance of 71.2 per cent with the histological grading. Robinson's cytological grading showed a diagnostic accuracy of 80.76 per cent with 77.77 per cent specificity while Mouriquand's method had an accuracy of 84.60 per cent with 33.33 per cent specificity.

INTERPRETATION & CONCLUSION: Though the Robinson's and Mouriquand's grading systems were found to have similar concordance with histological grading, Robinson's method was considered better because of its simplicity, and specificity.

摘要

背景与目的

细针穿刺（FNA）材料越来越多地用于确定乳腺癌患者的各种预后参数。有人建议细胞学分级应成为所有乳腺癌FNA报告的一部分，以便据此进行术前预后评估。然而，最能可靠反映广泛使用的组织学分级系统的细胞学分级方法尚未确定。本研究旨在比较两种细胞学分级方法的结果，以确定哪种方法与组织学分级的对应性更好。

方法

在一项双盲研究中，对52例乳腺癌患者使用两种不同的分级系统（罗宾逊法和莫里昆德法）进行细胞学分级，并将分级结果与组织学分级进行比较，以找出哪种方法更能准确反映组织学分级。

结果

采用罗宾逊法，分别有28.8%、46.2%和25%的穿刺样本被评为I级、II级和III级。采用莫里昆德分级法，相应的比例分别为9.6%、69.2%和21.2%。两种方法的比较显示，40例（76.9%）病例结果一致。两种细胞学分级系统与组织学分级的一致性均为71.2%。罗宾逊细胞学分级的诊断准确率为80.76%，特异性为77.77%；而莫里昆德法的准确率为84.60%，特异性为33.33%。