Stevens M W, Leong A S, Fazzalari N L, Dowling K D, Henderson D W
Division of Tissue Pathology, Institute of Medical and Veterinary Science, Adelaide, South Australia.
Diagn Cytopathol. 1992;8(4):333-41. doi: 10.1002/dc.2840080405.
Twenty-four cytologic features, previously reported to be useful in the distinction of malignant mesothelioma, adenocarcinoma, and benign mesothelial proliferation in serous effusions were assessed. Forty-four cases of malignant mesotheliomas, 46 cases of metastatic adenocarcinomas, and 30 cases of benign mesothelial proliferations were examined for these parameters. When these cytologic features were subjected to a stepwise logistic regression analysis, five features were selected to distinguish malignant mesothelioma from adenocarcinoma. These were true papillary aggregates, multinucleation with atypia, cell-to-cell apposition, acinus-like structures, and balloon-like vacuolation, the latter two features being characteristic of adenocarcinoma. The four variables selected to distinguish malignant mesothelioma from benign mesothelial proliferations were nuclear pleomorphism, macronucleoli, cell-in-cell engulfment, and monolayer cell groups, the latter being a feature of benign proliferations. Using these selected variables, the logistic model correctly predicted 95.4% of cases of malignant mesothelioma versus 100% of adenocarcinoma and 100% of malignant mesotheliomas versus 90% of benign mesothelial proliferations. The results of regression analysis suggest that many of the previously described cytologic features are not important diagnostic discriminators.
对先前报道的有助于鉴别浆液性积液中恶性间皮瘤、腺癌和良性间皮增生的24种细胞学特征进行了评估。对44例恶性间皮瘤、46例转移性腺癌和30例良性间皮增生进行了这些参数的检查。当对这些细胞学特征进行逐步逻辑回归分析时，选择了5个特征来区分恶性间皮瘤和腺癌。这些特征为真性乳头样聚集、非典型多核、细胞间贴附、腺泡样结构和气球样空泡化，后两个特征是腺癌的特征。选择用于区分恶性间皮瘤和良性间皮增生的4个变量为核多形性、大核仁、细胞内吞噬和单层细胞群，后者是良性增生的特征。使用这些选定的变量，逻辑模型正确预测了95.4%的恶性间皮瘤病例，腺癌的预测准确率为100%，恶性间皮瘤的预测准确率为100%，良性间皮增生的预测准确率为90%。回归分析结果表明，许多先前描述的细胞学特征并非重要的诊断鉴别指标。
