Montironi R, Alberti R, Sisti S, Braccischi A, Scarpelli M, Mariuzzi G M
Institute of Morbid Anatomy, University of Ancona, Italy.
Appl Pathol. 1989;7(6):367-74.
The aim of our study was to evaluate the validity of the quantitative analysis of nuclear features on aspiration smears in the distinction between follicular adenoma and follicular carcinoma. Karyometric and DNA features, including the nucleolar count, were evaluated on the cytologic material of 28 cases; the values were in general slightly higher in the carcinomas than in the adenomas, with overlap between the two diagnostic groups. By plotting the two most discriminant and least correlated parameters against each other and by drawing two straight lines (one perpendicular to the axis representing the mean of the major nuclear diameter at the 9-microns point, the other perpendicular to the axis of the percentage of nucleolated cells at the 75% point), we obtained two regions: a rectangle delimited by the two axes and the two lines containing 86% of adenomas, and the remaining part of the plane containing 79% of carcinomas. The validity of this approach was tested in 32 new cases not included in the original bivariate classification: accuracy 87%; sensitivity 86%; specificity 88%; predictive value of adenoma 88%; predictive value of carcinoma 85%. In conclusion, a simple cytometric method, i.e., the combined evaluation of the mean of the major nuclear diameter with the percentage of nucleolated nuclei, allows a substantial distinction to be made between follicular adenoma and carcinoma.
我们研究的目的是评估细针穿刺涂片细胞核特征定量分析在鉴别滤泡性腺瘤和滤泡性癌中的有效性。对28例病例的细胞学材料评估了包括核仁计数在内的核测量和DNA特征；一般来说，癌组织中的这些值略高于腺瘤组织，两个诊断组之间存在重叠。通过将两个最具鉴别力且相关性最小的参数相互绘制，并绘制两条直线（一条垂直于代表9微米点处主要核直径平均值的轴，另一条垂直于75%点处有核仁细胞百分比的轴），我们得到了两个区域：由两条轴和两条直线界定的矩形区域，包含86%的腺瘤，平面的其余部分包含79%的癌。在最初双变量分类中未纳入的32例新病例中测试了该方法的有效性：准确率87%；敏感性86%；特异性88%；腺瘤的预测值88%；癌的预测值85%。总之，一种简单的细胞计数方法，即主要核直径平均值与有核仁细胞核百分比的联合评估，能够在滤泡性腺瘤和癌之间做出实质性区分。
