Department of Gastroenterology, Tokyo Women's Medical University, Japan.
Pancreatology. 2013 Jul-Aug;13(4):369-78. doi: 10.1016/j.pan.2013.06.003. Epub 2013 Jun 22.
Precise histological diagnosis is important for the successful management of intraductal papillary mucinous neoplasms (IPMNs).
The object of this study was to determine whether cell block cytology is useful for preoperative cytomorphological grading and typing of IPMNs.
The subjects were 23 patients with IPMN from whom pancreatic juice was collected via a pancreatic catheter and who subsequently underwent pancreatic resection.
In 20 of the 23 cases, the quantity of cells collected for cell block cytology was sufficient to enable typing and grading of the IPMN. The rates of consistency between the results of typing and grading by cell block cytology and histological examination of the surgical specimen were 95% and 80%, respectively. Typing of the 10 main-duct/mixed-duct-type IPMNs by cell block cytology yielded 5 gastric types, 3 intestinal types, 1 oncocytic type, and 1 pancreatobiliary type, and the typing was consistent with the surgical diagnosis in all 10 cases. The results of typing of the branch-duct-type IPMNs by cell block cytology were identical to the results of histological typing in the surgical specimens in every case but one. However, the specificity of cell block cytology for grading IPMNs was 55.6%.
The cell block cytological findings were fairly consistent with the histopathological features of the surgical specimens, thereby indicating that cell block cytology may be useful for preoperative and typing of IPMNs, but only play a supplementary role in grading IPMNs.
准确的组织学诊断对于成功治疗胰管内乳头状黏液性肿瘤（IPMN）至关重要。
本研究旨在确定细胞块细胞学是否有助于 IPMN 的术前细胞形态学分级和分型。
研究对象为 23 例通过胰管导管收集胰液并随后接受胰腺切除术的 IPMN 患者。
在 23 例病例中，有 20 例收集到足够数量的细胞进行细胞块细胞学分型和分级。细胞块细胞学分型和手术标本组织学检查结果的一致性率分别为 95%和 80%。10 例主-胰管/混合-胰管型 IPMN 的细胞块细胞学分型结果为 5 例胃型、3 例肠型、1 例嗜酸性细胞型和 1 例胰胆管型，与 10 例手术诊断完全一致。细胞块细胞学对分支胰管型 IPMN 的分型结果与手术标本的组织学分型结果完全一致，但有 1 例除外。然而，细胞块细胞学对 IPMN 分级的特异性为 55.6%。
细胞块细胞学结果与手术标本的组织病理学特征相当一致，表明细胞块细胞学可能有助于术前 IPMN 的诊断和分型，但仅在 IPMN 的分级中起辅助作用。
