Crissman J D, Drozdowicz S, Johnson C, Kini S R
Department of Pathology, Henry Ford Hospital, Detroit, Michigan.
Anal Quant Cytol Histol. 1991 Oct;13(5):321-8.
The differentiation of hyperplastic nodules, follicular adenomas and follicular carcinomas from fine needle aspiration (FNA) cytology smears may be difficult. To better define the diagnostic criteria, we studied the morphometric parameters of nuclear area (NA), nuclear:cytoplasmic ratio and nuclear roundness (NR) in single cells and cell aggregates. In addition, we quantitated the percentage of touching or overlapping nuclei (NO) and the percentage of extent of nuclear area of overlap (NAO) in cellular aggregates. We measured cellular samples from FNA aspirates obtained from 20 hyperplastic nodules, 21 follicular adenomas, 5 encapsulated follicular carcinomas and 22 invasive follicular carcinomas, all of which were subsequently confirmed by histologic examination. Cellular aggregates provided the maximum diagnostic information. Stepwise discriminant analysis revealed that nuclear size, nuclear roundness and the percentage NAO allow optimum differentiation of hyperplasia, adenomas and carcinomas. Clearly, all of the poorly differentiated carcinomas (large NA, low NR, high NO and NAO) could be reliably diagnosed. Discriminant analysis allowed the differentiation of carcinoma from adenoma in 20/22 carcinomas (91%) and all 21 adenomas (although 2 adenomas were called hyperplasias and 3 hyperplasias were called adenomas).
通过细针穿刺（FNA）细胞学涂片鉴别增生性结节、滤泡性腺瘤和滤泡性癌可能具有挑战性。为了更好地界定诊断标准，我们研究了单细胞和细胞聚集体中核面积（NA）、核质比及核圆度（NR）的形态测量参数。此外，我们还对细胞聚集体中相互接触或重叠的细胞核百分比（NO）以及核面积重叠程度百分比（NAO）进行了定量分析。我们测量了来自20个增生性结节、21个滤泡性腺瘤、5个包膜性滤泡性癌和22个浸润性滤泡性癌的FNA穿刺所得的细胞样本，所有样本随后均经组织学检查证实。细胞聚集体提供了最大的诊断信息。逐步判别分析显示，核大小、核圆度和NAO百分比有助于最佳地区分增生、腺瘤和癌。显然，所有低分化癌（大NA、低NR、高NO和NAO）均可得到可靠诊断。判别分析能够在22例癌中的20例（91%）以及所有21例腺瘤中区分癌与腺瘤（尽管有2例腺瘤被诊断为增生，3例增生被诊断为腺瘤）。
