Sayar Hamide, Bulut Burak Besir, Bahar Abdulkadir Yasir, Bahar Mustafa Remzi, Seringec Nurten, Resim Sefa, Çıralık Harun
Department of Pathology, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey.
Diagn Cytopathol. 2015 Feb;43(2):91-7. doi: 10.1002/dc.23187. Epub 2014 Jun 26.
To evaluate the accuracy of imprint cytology of core needle biopsy specimens in the diagnosis of prostate cancer.
Between December 24, 2011 and May 9, 2013, patients with an abnormal DRE and/or serum PSA level of >2.5 ng/mL underwent transrectal prostate needle biopsy. Samples with positive imprint cytology but negative initial histologic exam underwent repeat sectioning and histological examination.
1,262 transrectal prostate needle biopsy specimens were evaluated from 100 patients. Malignant imprint cytology was found in 236 specimens (18.7%), 197 (15.6%) of which were confirmed by histologic examination, giving an initial 3.1% (n = 39) rate of discrepant results by imprint cytology. Upon repeat sectioning and histologic examination of these 39 biopsy samples, 14 (1.1% of the original specimens) were then diagnosed as malignant, 3 (0.2%) as atypical small acinar proliferation (ASAP), and 5 (0.4%) as high-grade prostatic intraepithelial neoplasia (HGPIN). Overall, 964 (76.4%) specimens were negative for malignancy by imprint cytology. Seven (0.6%) specimens were benign by cytology but malignant cells were found on histological evaluation. On imprint cytology examination, nonmalignant but abnormal findings were seen in 62 specimens (4.9%). These were all due to benign processes. After reexamination, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate of imprint preparations were 98.1, 96.9, 98.4, 92.8, 99.3, 1.6, 3.1%, respectively.
Imprint cytology is valuable tool for evaluating TRUS-guided core needle biopsy specimens from the prostate. Use of imprint cytology in combination with histopathology increases diagnostic accuracy when compared with histopathologic assessment alone.
评估经皮穿刺活检标本印片细胞学检查在前列腺癌诊断中的准确性。
2011年12月24日至2013年5月9日期间，对直肠指检异常和/或血清前列腺特异抗原（PSA）水平>2.5 ng/mL的患者进行经直肠前列腺穿刺活检。印片细胞学检查阳性但初始组织学检查阴性的样本进行再次切片和组织学检查。
对100例患者的1262份经直肠前列腺穿刺活检标本进行了评估。236份标本（18.7%）印片细胞学检查发现恶性细胞，其中197份（15.6%）经组织学检查确诊，印片细胞学检查初始结果不一致率为3.1%（n = 39）。对这39份活检样本进行再次切片和组织学检查后，14份（占原始标本的1.1%）被诊断为恶性，3份（0.2%）为非典型小腺泡增生（ASAP），5份（0.4%）为高级别前列腺上皮内瘤变（HGPIN）。总体而言，964份（76.4%）标本印片细胞学检查未发现恶性细胞。7份（0.6%）标本细胞学检查为良性，但组织学评估发现恶性细胞。在印片细胞学检查中，62份标本（4.9%）发现非恶性但异常的结果，均由良性病变引起。重新检查后，印片标本的准确性、敏感性、特异性、阳性预测值、阴性预测值、假阳性率、假阴性率分别为98.1%、96.9%、98.4%、92.8%、99.3%、1.6%、3.1%。
印片细胞学检查是评估经直肠超声引导下前列腺穿刺活检标本的有价值工具。与单纯组织病理学评估相比，印片细胞学检查与组织病理学检查联合使用可提高诊断准确性。
