Fuhr J E, Kattine A A, Nelson H S
Section of Experimental Pathology, University of Tennessee Medical Center, Knoxville 37920.
J Natl Cancer Inst. 1992 Aug 19;84(16):1272-6. doi: 10.1093/jnci/84.16.1272.
Malignancy of the breast is frequently diagnosed through fine needle aspiration. In the hands of a skilled aspirator and cytopathologist, this can be a highly accurate procedure.
This study was undertaken to evaluate whether sufficient residual cells in the bore of the needle could be harvested and analyzed efficiently by flow cytometry analysis. The goal was then to determine the value of routine flow cytometry as an adjunctive technology in the interpretation of breast fine needle aspirations.
Cells were rinsed from the needles of 83 consecutive diagnostic fine needle aspirates after preliminary inspection had confirmed adequate material was obtained for cytopathology. Cells were washed, and nuclei prepared by detergent treatment. After ribonuclease treatment, DNA was stained with the fluorescent marker propidium iodide. DNA content per cell was determined by flow cytometry by measurement of right-angle fluorescence.
Less than 4% of the samples were rejected for inadequate cell numbers. Flow cytometry criteria for evidence of malignancy included the presence of a DNA aneuploid population or an elevated rate of proliferation (13% or higher) of a diploid population. Accuracy of flow cytometry was based on cytopathologic interpretation in all cases except two which were based on results of excisional biopsy. The sensitivity of the flow cytometry analysis was 76%; the specificity was 100%, with results from flow cytometry pivotal in the correct diagnoses for two patients whose cytopathologic results were equivocal. Analysis of histograms indicated acceptable coefficients of variation for all populations. Gating analysis indicated the suitability of the material for this type of study, with an average of 85% of the events selected, or "gated in." Low recoveries were associated with the presence of necrotic debris in the sample.
Flow cytometry can be a valuable adjunctive technology, capable of providing the cytopathologist with additional information regarding the character of cells analyzed.
乳腺癌常通过细针穿刺活检来诊断。在技术娴熟的穿刺者和细胞病理学家手中，这可以是一个高度准确的程序。
本研究旨在评估能否通过流式细胞术分析有效地获取并分析针腔内足够的残留细胞。目标是确定常规流式细胞术作为辅助技术在乳腺细针穿刺活检结果解读中的价值。
在初步检查确认已获取足够用于细胞病理学检查的材料后，从83例连续诊断性细针穿刺活检的针中冲洗细胞。对细胞进行洗涤，并用去污剂处理制备细胞核。经核糖核酸酶处理后，用荧光标记碘化丙啶对DNA进行染色。通过测量直角荧光，用流式细胞术测定每个细胞的DNA含量。
不到4%的样本因细胞数量不足而被拒收。流式细胞术诊断恶性肿瘤的标准包括存在DNA非整倍体群体或二倍体群体增殖率升高（13%或更高）。除两例基于切除活检结果外，所有病例流式细胞术的准确性均基于细胞病理学解读。流式细胞术分析的敏感性为76%；特异性为100%，对于两名细胞病理学结果不明确的患者，流式细胞术结果对正确诊断起关键作用。直方图分析表明所有群体的变异系数均可接受。门控分析表明该材料适用于此类研究，平均有85%的事件被选中，即“被门控”。回收率低与样本中存在坏死碎片有关。
流式细胞术可以是一种有价值的辅助技术，能够为细胞病理学家提供有关所分析细胞特征的额外信息。
