Silverman J F, Finley J L, O'Brien K F, Dabbs D J, Park H K, Larkin E W, Norris H T
Department of Clinical Pathology and Diagnostic Medicine, School of Medicine, East Carolina University, Greenville, NC 27834.
Acta Cytol. 1989 Nov-Dec;33(6):791-6.
A statistical analysis of the accuracy of the immediate interpretation of 425 fine needle aspiration (FNA) biopsies from various sites was performed. Preliminary interpretation of Diff-Quik-stained smears was rendered within a few minutes after performing the FNA biopsy, using diagnostic terminology similar to that of a surgical pathology report. The immediate assessment was documented in the formal cytology report and compared to the final diagnosis. For the entire series, the immediate interpretation had a sensitivity of 96%, a specificity of 97%, a positive predictive value (PV) of 98%, a negative PV of 95% and an efficiency of the test of 96%. There were 14 false-negative or falsely insufficient immediate interpretations and one false-positive immediate diagnosis. The diagnostic accuracy of the immediate interpretation of FNA biopsies from specific sites was also calculated; FNA biopsies of the pancreas were the least accurate procedure, having a sensitivity of 60% but a specificity of 100%. The role of the immediate interpretation of FNA biopsies is similar to the use of frozen sections in surgical pathology. An immediate assessment can (1) determine whether an adequate specimen is present, (2) render a specific preliminary diagnosis, (3) guide further clinical investigations or treatment, and (4) determine whether ancillary studies are needed to make a more accurate or specific diagnosis from the FNA specimen. Our results indicate that the immediate interpretation of FNA biopsies is an accurate procedure that should be routinely employed.
对来自不同部位的425例细针穿刺（FNA）活检的即时判读准确性进行了统计分析。在进行FNA活检后的几分钟内，使用与外科病理报告类似的诊断术语，对Diff-Quik染色涂片进行初步判读。即时评估记录在正式的细胞学报告中，并与最终诊断进行比较。对于整个系列，即时判读的敏感性为96%，特异性为97%，阳性预测值（PV）为98%，阴性PV为95%，检测效率为96%。有14例假阴性或即时判读错误不足的情况，以及1例假阳性即时诊断。还计算了特定部位FNA活检即时判读的诊断准确性；胰腺的FNA活检是最不准确的操作，敏感性为60%，但特异性为100%。FNA活检即时判读的作用类似于外科病理中冰冻切片的使用。即时评估可以（1）确定是否有足够的标本，（2）做出特定的初步诊断，（3）指导进一步的临床检查或治疗，以及（4）确定是否需要辅助研究以从FNA标本中做出更准确或特异的诊断。我们的结果表明，FNA活检的即时判读是一种准确的操作，应常规采用。
