Department of Pathology, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
APMIS. 2010 Feb;118(2):150-5. doi: 10.1111/j.1600-0463.2009.02575.x.
The aim of this study was to determine the most significant cytologic features to differentiate small cell carcinoma (SCC) from poorly differentiated non-small cell carcinoma (NSCC) in bronchial lavage specimens. Bronchial lavage specimens from 35 SCC cases and 63 poorly differentiated NSCC cases were examined and the cytologic parameters reviewed retrospectively. Thirty-five cytologic features considered useful in differential diagnosis were assessed. Statistical analysis indicated that salt and pepper chromatin, small cell size and nuclear molding have more than 90% sensitivity and 70% specificity for SCC cases. Logistic regression analysis demonstrated that the most effective criteria to differentiate SCC from poorly differentiated NSCC are small cell size, salt and pepper chromatin, prominent nucleolus and papilla formation. When these selected variables were used, sensitivity for predicting SCC was 94.3% and specificity 96.8%, and sensitivity for predicting NSCC was 96.8% and specificity 94.3%. There are several cytologic features, which are highly sensitive and specific for distinguishing SCC from NSCC. Nuclear features such as chromatin pattern, and size of the nucleoli and nuclei are more valuable than cytoplasmic features to distinguish between the two.
本研究旨在确定支气管灌洗标本中小细胞癌 (SCC) 与低分化非小细胞癌 (NSCC) 之间具有鉴别意义的最重要细胞学特征。回顾性分析了 35 例 SCC 病例和 63 例低分化 NSCC 病例的支气管灌洗标本，并对细胞学参数进行了评估。评估了 35 种被认为有助于鉴别诊断的细胞学特征。统计学分析表明，椒盐样染色质、小细胞大小和核塑形对 SCC 病例具有超过 90%的敏感性和 70%的特异性。Logistic 回归分析表明，区分 SCC 和低分化 NSCC 的最有效标准是小细胞大小、椒盐样染色质、明显的核仁及乳头形成。当使用这些选定的变量时，预测 SCC 的敏感性为 94.3%，特异性为 96.8%，预测 NSCC 的敏感性为 96.8%，特异性为 94.3%。有几个细胞学特征对区分 SCC 和 NSCC 具有高度的敏感性和特异性。核特征，如染色质模式、核仁大小和核大小，比细胞质特征更有助于区分两者。
