Saleh A F M, Nahar Rahman A J E, Salam M A, Islam F
Deptt. of Pathology, Dinajpur Medical College, Dinajpur.
Bangladesh Med Res Counc Bull. 2005 Dec;31(3):95-103.
This study was carried-out to evaluate the diagnostic accuracy of fine needle aspiration cytology (FNAC) and the role of FNAC in the diagnosis of prostatic lesions. FNAC was performed on 64 patients presented with enlarged prostate. Cytological diagnosis by fine needle aspiration (FNA) of the prostate was compared with histological diagnosis in 60 patients. Of these, 42 cases were cytologically diagnosed as benign lesions, 18 cases as malignant. In remaining 4 cases, materials were inadequate for diagnosis in one case and biopsy materials were not available in 3 cases. On histological examination, 42 cases which were cytologically diagnosed as benign, 40 cases were found to be benign and 2 cases were malignant histologically leading to 2 false negative diagnoses. Of the 18 cases diagnosed cytologically as malignant (considering atypical hyperplasia and carcinoma as malignant), 15 cases were proved to be so by histological examination. So there were false positive diagnoses in 3 cases. No patient suffered from any complication following the aspiration biopsy. The sensitivity of this study for detection of prostatic carcinoma was 88 percent; specificity was 93 percent and diagnostic accuracy 91.7 percent. In this prospective study, FNAC of prostate was found to be associated with high diagnostic yields. These data support the value of transrectal FNAC as sensitive, easy to perform method for sampling of an enlarged prostate. The procedure may be used as an efficient primary screening tool in the diagnosis of prostatic lesions. Frequent use of this technique in our country should be encouraged.
本研究旨在评估细针穿刺细胞学检查(FNAC)的诊断准确性以及FNAC在前列腺病变诊断中的作用。对64例前列腺肿大患者进行了FNAC检查。将60例患者前列腺细针穿刺(FNA)的细胞学诊断与组织学诊断进行了比较。其中,42例细胞学诊断为良性病变,18例为恶性。其余4例中,1例取材不足无法诊断,3例无活检材料。组织学检查显示,细胞学诊断为良性的42例中,40例组织学为良性,2例为恶性,导致2例假阴性诊断。在细胞学诊断为恶性的18例(将非典型增生和癌视为恶性)中,15例经组织学检查证实。因此有3例假阳性诊断。穿刺活检后无患者出现任何并发症。本研究检测前列腺癌的敏感性为88%;特异性为93%,诊断准确性为91.7%。在这项前瞻性研究中,发现前列腺FNAC具有较高的诊断率。这些数据支持经直肠FNAC作为一种敏感、易于操作的方法用于肿大前列腺取样的价值。该方法可作为前列腺病变诊断的一种有效的初步筛查工具。应鼓励在我国频繁使用该技术。