肝脏细针穿刺细胞学中的微核评分

Micronucleus scoring in liver fine needle aspiration cytology.

作者信息

Wen C-H, Lin C-H, Tsao S-C, Su Y-C, Tsai M-H, Chai C-Y

机构信息

Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Pathology, Foo-Yin University Hospital, Ping-Tong Hsien, TaiwanGraduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Pathology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Cytopathology. 2013 Dec;24(6):391-5. doi: 10.1111/cyt.12009. Epub 2012 Sep 14.

DOI:10.1111/cyt.12009

PMID:22974178

Abstract

OBJECTIVE

This study evaluated the role of the micronucleus (MN) in liver fine needle aspiration (FNA) cytology.

METHODS

Histological features of 75 cases of hepatocellular carcinoma (HCC), of which 25 were well differentiated, 37 moderately differentiated and 13 poorly differentiated, and 58 benign hepatic lesions (total, 133 cases) were correlated with MN expression observed in FNA smears reported as benign (n =40), atypical (n = 14), suspicious (n = 30) and malignant (n =49).

RESULTS

Stepwise increases in the MN score (0.4 ± 0.6, 1.2 ± 1.3, 6.3 ± 4.2 and 14.8 ± 8.8) correlated with the degree of cytological abnormality: benign, atypia, suspicious and malignant, respectively. The mean MN scores for well-, moderately and poorly differentiated HCC were 5.4 ± 2.2, 11.5 ± 4.5 and 24.9 ± 9.1, respectively, which was significantly different between malignant and suspicious (P < 0.0001), between suspicious and atypical (P= 0.008) but not between atypical and benign. The MN scores differed significantly between all degrees of differentiation of HCC and between the HCC and benign hepatic lesions (P < 0.0001). High sensitivity, specificity and accuracy of liver FNA for diagnosing HCC (96%, 98%, and 96%, respectively) were obtained at a cutoff of three for the MN score.

CONCLUSIONS

The MN score is an effective HCC biomarker and has a good potential use as an ancillary tool for diagnosing HCC using FNA cytology.

摘要

目的

本研究评估微核（MN）在肝脏细针穿刺抽吸（FNA）细胞学中的作用。

方法

75例肝细胞癌（HCC）的组织学特征，其中25例高分化，37例中分化，13例低分化，以及58例良性肝病变（共133例）与FNA涂片观察到的MN表达相关，FNA涂片报告为良性（n = 40）、非典型（n = 14）、可疑（n = 30）和恶性（n = 49）。

结果

MN评分逐步增加（0.4±0.6、1.2±1.3、6.3±4.2和14.8±8.8）分别与细胞学异常程度相关：良性、非典型、可疑和恶性。高分化、中分化和低分化HCC的平均MN评分分别为5.4±2.2、11.5±4.5和24.9±9.1，恶性与可疑之间（P < 0.0001）、可疑与非典型之间（P = 0.008）差异有统计学意义，但非典型与良性之间无差异。HCC各分化程度之间以及HCC与良性肝病变之间的MN评分差异有统计学意义（P < 0.0001）。MN评分截断值为3时，肝脏FNA诊断HCC具有较高的敏感性、特异性和准确性（分别为96%、98%和96%）。