Sukheeja Deepti, Singhvi Shashi, Rai Naresh N, Midya Manojit
Senior Resident, Department of Pathology, Government Medical College & Associated Group of Hospitals , Kota, Rajasthan, India .
Retired Head of the Dapartment, Department of Pathology, SMS Medical College & Hospital , Jaipur, Rajasthan, India .
J Clin Diagn Res. 2015 Aug;9(8):EC01-3. doi: 10.7860/JCDR/2015/12372.6281. Epub 2015 Aug 1.
Although radiological imaging and surgical techniques have substantially improved, assessment of prognosis by grading astrocytoma has been challenging task for pathologists. We have tried to assess these tumours intraoperatively for rapid diagnosis. Also MIB-1Labelling index (MIB-1 LI) was done to study their proliferative activity.
To compare and grade squash smear technique with histopathology to study its utility in diagnosis of astrocytomas. Further, to study correlation of various grades with their MIB-1 labelling index.
This study was carried out in the Department of Pathology, SMS Medical College, Jaipur over a period of one year.
Forty five cases of radiologically suspected astrocytomas were submitted for intraoperative cytology and later for histopathology. Two techniques were compared for ability to diagnose as well as grade the tumour. Also, MIB-1 LI were performed in biopsy tissue. Histopathological and immunological grades were compared.
Out of 45 cases 44(97.7%) correctly diagnosed by squash smear technique. Further significant differences seen in values of MIB-1 LI of high-grade and low-grade astrocytomas. A progressive increase in the MIB-1 LI was observed with increasing grades. In grade I astrocytoma MIB-1 LI was <0.05%. In grade II astrocytoma it varied from 0.8-2.6% except in one case where it was 3.2% who presented with a recurrent mass. In grade III, MIB-1 LI was 3.5% to 7.5%. In grade IV was 10-20%.
Intraoperative cytology is fairly accurate and useful in intraoperative consultation. Also, MIB-1 LI can be a useful adjunct for grading particularly in small biopsies.
尽管放射影像学和外科技术有了显著进步，但对病理学家而言，通过对星形细胞瘤进行分级来评估预后一直是一项具有挑战性的任务。我们尝试在术中对这些肿瘤进行评估以实现快速诊断。同时进行了MIB-1标记指数（MIB-1 LI）检测以研究其增殖活性。
比较并分级压片涂片技术与组织病理学，以研究其在星形细胞瘤诊断中的效用。此外，研究不同分级与MIB-1标记指数之间的相关性。
本研究在斋浦尔SMS医学院病理科进行，为期一年。
45例放射学怀疑为星形细胞瘤的病例被提交进行术中细胞学检查，随后进行组织病理学检查。比较了两种技术对肿瘤的诊断及分级能力。同时，对活检组织进行了MIB-1 LI检测。比较了组织病理学分级和免疫分级。
45例病例中，44例（97.7%）通过压片涂片技术得到正确诊断。此外，高级别和低级别星形细胞瘤的MIB-1 LI值存在显著差异。随着分级增加，MIB-1 LI呈逐渐上升趋势。在I级星形细胞瘤中，MIB-1 LI<0.05%。在II级星形细胞瘤中，其范围为0.8 - 2.6%，但有1例复发肿块患者的MIB-1 LI为3.2%。在III级中，MIB-1 LI为3.5%至7.5%。在IV级中为10 - 20%。
术中细胞学在术中会诊中相当准确且有用。此外，MIB-1 LI可作为分级的有用辅助手段，尤其在小活检中。
