Bandoh Nobuyuki, Goto Takashi, Akahane Toshiaki, Ohnuki Natsumi, Yamaguchi Tomomi, Kamada Hajime, Harabuchi Yasuaki, Tanaka Shinya, Nishihara Hiroshi
Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan.
Department of Biology and Genetics, Laboratory of Cancer Medical Science, Hokuto Hospital, Obihiro, Hokkaido, Japan.
Diagn Cytopathol. 2016 Mar;44(3):169-76. doi: 10.1002/dc.23402. Epub 2016 Jan 9.
Cervical lymphadenopathy is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration (FNA) cytology has been widely used for the diagnosis of cervical lymphadenopathy. However, some limitations of the diagnostic accuracy using conventional smear (CS) cytology have been pointed out. The diagnostic value of liquid-based cytology (LBC) with FNA specimens has not yet been fully proven.
Forty-two patients with cervical lymphadenopathy who underwent FNA with CS cytology from 2007 to 2011 and 123 patients who underwent FNA with LBC utilizing LBCPREP2™ from 2011 to 2015 were studied. Diagnostic values were compared between the CS and the LBC groups.
Of the total 165 patients representing the combined CS and LBC groups, 81 (49.1%) were diagnosed as benign lymph node and 84 (50.9%) were malignant diseases including 37 (22.4%) of metastatic carcinoma except for thyroid carcinoma, 30 (18.2%) of metastatic thyroid carcinoma, and 17 (10.3%) of malignant lymphoma. The overall statistical values including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CS were 75%, 100%, 100%, 78.9%, and 87.1%, respectively, whereas those values for LBC were 91.2%, 100%, 100%, 90.7%, and 95.3%, respectively. The sensitivity of LBC for malignant diseases tended to be higher than that of CS cytology (p = 0.081).
LBC with FNA specimens from cervical lymphadenopathy is a useful and reliable method for the diagnosis of malignant diseases, especially of metastatic carcinomas, due to its increased sensitivity compared with CS cytology.
颈部淋巴结病是门诊患者中常见的症状，区分恶性病变与反应性淋巴组织增生很重要。细针穿刺（FNA）细胞学已广泛用于颈部淋巴结病的诊断。然而，传统涂片（CS）细胞学诊断准确性存在一些局限性。FNA标本的液基细胞学（LBC）诊断价值尚未得到充分证实。
对2007年至2011年接受CS细胞学FNA检查的42例颈部淋巴结病患者和2011年至2015年使用LBCPREP2™进行LBC检查的123例患者进行研究。比较CS组和LBC组的诊断价值。
CS组和LBC组合并的165例患者中，81例（49.1%）被诊断为良性淋巴结，84例（50.9%）为恶性疾病，其中除甲状腺癌外的转移性癌37例（22.4%），转移性甲状腺癌30例（18.2%），恶性淋巴瘤17例（10.3%）。CS的总体统计值包括敏感性、特异性、阳性预测值、阴性预测值和准确性分别为75%、100%、100%、78.9%和87.1%，而LBC的这些值分别为91.2%、100%、100%、90.7%和95.3%。LBC对恶性疾病的敏感性往往高于CS细胞学（p = 0.081）。
对于颈部淋巴结病的FNA标本，LBC是诊断恶性疾病，尤其是转移性癌的一种有用且可靠的方法，因为与CS细胞学相比，其敏感性有所提高。
