Das Dilip K, Sharma Prem N
Department of Pathology, Faculty of Medicine, and Health Sciences Computer Center, Kuwait University, Safat, Kuwait.
Anal Quant Cytol Histol. 2005 Apr;27(2):83-94.
To determine the advantage of examining fine needle aspiration (FNA) smears of papillary thyroid carcinoma (PTC) under a 100 x oil-immersion objective, which is capable of optically sectioning the cells.
Two hundred neoplastic cells were counted under a high-power (40x) objective as well as oil-immersion (100x) objective in 54 PTC cases classified into variants: 14 follicular neoplasms, 8 Hürthle cell neoplasms, 5 medullary thyroid carcinomas and 9 hyperplastic lesions. The counts of cells with 2 important diagnostic features of PTC, intranuclear cytoplasmic inclusions (INCIs) and grooved nuclei, were compared between various groups and between high-power and oil-immersion objectives in each group.
Cytomorphologic features, such as INCI and nuclear grooves, were visible usually under 2 or 3 focal planes under the oil-immersion objective as opposed to a single plane under the high-power objective. In PTC cases, the mean cell count, 10.1 (+/- 1.75 SE) with INCIs, under the oil-immersion objective was significantly higher than the count, 6.1 (+/- 1.32 SE), under the high-power objective (p = 0.023). INCIs were not observed under the high-power objectives in 11 (20.4%) PTC cases, but in 5 (45.5%) of these they were visible under the oil-immersion objective. In PTC the mean cell count, 88.0 (+/- 4.96 SE), with grooved nuclei under the oil-immersion objective was also significantly higher than the count, 69.5 (+/- 4.87 SE), under the high-power objective (p = 0.010). Under the high-power objective, < 20.0% of cells with grooved nuclei were observed in 12 (22.2%) cases of PTC. However, examination under the oil-immersion objective revealed > or = 20.0% cells with grooved nuclei in 9 (75%) of these. In PTC the mean cell counts with INCIs as well as grooved nuclei under the oil-immersion objective were significantly higher than those of follicular neoplasms, Hürthle cell neoplasms, medullary carcinoma and hyperplastic lesions.
In PTC, examination of FNA smears for INCIs and grooved nuclei under an oil-immersion objective was diagnostically more useful as compared to a high-power objective.
确定在100倍油镜下检查甲状腺乳头状癌（PTC）细针穿刺（FNA）涂片的优势，该油镜能够对细胞进行光学切片。
在54例PTC病例中，将其分为不同亚型：14例滤泡性腺瘤、8例许特莱细胞腺瘤、5例髓样癌和9例增生性病变，在高倍镜（40倍）及油镜（100倍）下对200个肿瘤细胞进行计数。比较不同组之间以及每组中高倍镜和油镜下具有PTC两个重要诊断特征的细胞计数，即核内假包涵体（INCIs）和沟状核。
与高倍镜下通常仅一个焦平面可见不同，细胞形态学特征，如INCIs和核沟，在油镜下通常在2或3个焦平面可见。在PTC病例中，油镜下具有INCIs的细胞平均计数为10.1（±1.75标准误），显著高于高倍镜下的计数6.1（±1.32标准误）（p = 0.023）。在11例（20.4%）PTC病例的高倍镜下未观察到INCIs，但其中5例（45.5%）在油镜下可见。在PTC中，油镜下具有沟状核的细胞平均计数为88.0（±4.96标准误），也显著高于高倍镜下的计数69.5（±4.87标准误）（p = 0.010）。在高倍镜下，12例（22.2%）PTC病例中观察到具有沟状核的细胞<20.0%。然而，在油镜下检查发现其中9例（75%）具有沟状核的细胞≥20.0%。在PTC中，油镜下具有INCIs以及沟状核的细胞平均计数显著高于滤泡性腺瘤、许特莱细胞腺瘤、髓样癌和增生性病变。
在PTC中，与高倍镜相比，在油镜下检查FNA涂片的INCIs和沟状核在诊断上更有用。
