细胞块在腹部肿块细针穿刺抽吸活检引导中的作用。

Role of Cell Block in Guided FNAC of Abdominal Masses.

作者信息

Vinayakamurthy Shashikala, Manoli Nandini, Shivajirao Prathima, Jothady Sunila

机构信息

Assistant Professor, Deprtment of Pathology, Vydehi Institute of Medical Sciences and Research Centre , Bangalore, India .

Professor, Department of Pathology, JSS University , Karnataka, India .

出版信息

J Clin Diagn Res. 2016 Mar;10(3):EC01-5. doi: 10.7860/JCDR/2016/17359.7422. Epub 2016 Mar 1.

DOI:10.7860/JCDR/2016/17359.7422

PMID:27134875

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4843261/

Abstract

INTRODUCTION

Fine Needle Aspiration (FNA) of space occupying lesions in superficial or deep anatomic sites is an increasingly common procedure, providing rapid and safe diagnosis. However, sometimes FNA does not yield sufficient information for a precise diagnosis and the risk of false negatives and indeterminate diagnosis is always present. Therefore, we attempted to obtain additional information via the preparation of Cell Block (CB) from the residual material of aspirates and thus enhance the diagnostic accuracy.

AIM

This study was carried out to evaluate the role of CB as a useful adjunct to smears for establishing a more definitive cytopathologic diagnosis and for its utility in special staining and Immuno-histochemistry (IHC).

MATERIALS AND METHODS

A total of 66 cases of image-guided FNA of abdominal masses were studied. In addition to the routine smears, CBs were prepared from the residual tissues for all possible cases and its diagnostic efficacy was analysed. Further, the use of CBs for special staining and IHC was also established.

RESULTS

This study included a total of 66 patients with abdominal masses who were referred for guided FNA cytology. Out of these cases, adequate material was obtained on FNAC in 64 cases (96.96%) and on CB in 45 cases (68.18%) and the diagnosis was provided. There was a good agreement between the FNA smear diagnosis and CB diagnosis. The histopathology of CB sections further helped in precise final cytopathological diagnosis. Two FNA smears were unsatisfactory for evaluation and hence the diagnosis was done on CB sections alone. With FNA cytology and CB in combination, a cytopathological diagnosis was given for all the 66 cases. The sensitivity of FNA in comparison to the histopathology of CB was 91.6% and specificity was 88.8%. The diagnostic accuracy was 62% and the discordance was 6%.

CONCLUSIONS

CB in addition to the routine FNA is a simple, reliable and cost-effective technique that further contributes to the final cytopathological diagnosis.

摘要

引言

对浅表或深部解剖部位的占位性病变进行细针穿刺抽吸（FNA）是一种越来越常见的操作，可提供快速且安全的诊断。然而，有时FNA无法提供足够信息以进行精确诊断，假阴性和诊断不明确的风险始终存在。因此，我们试图通过用穿刺抽吸物的残余材料制备细胞块（CB）来获取更多信息，从而提高诊断准确性。

目的

本研究旨在评估CB作为涂片的有用辅助手段在建立更明确的细胞病理学诊断以及其在特殊染色和免疫组织化学（IHC）中的效用。

材料与方法

共研究了66例腹部肿块影像引导下FNA病例。除常规涂片外，对所有可能的病例均用残余组织制备CB，并分析其诊断效能。此外，还确立了CB在特殊染色和IHC中的应用。

结果

本研究共纳入66例因引导下FNA细胞学检查而转诊的腹部肿块患者。在这些病例中，64例（96.96%）通过细针穿刺抽吸活检（FNAC）获得了足够材料，45例（68.18%）通过CB获得了足够材料并作出了诊断。FNA涂片诊断与CB诊断之间具有良好的一致性。CB切片的组织病理学进一步有助于精确的最终细胞病理学诊断。有2例FNA涂片评估不满意，因此仅根据CB切片作出诊断。结合FNA细胞学检查和CB，对所有66例病例均作出了细胞病理学诊断。与CB组织病理学相比，FNA的敏感性为91.6%，特异性为88.8%。诊断准确性为62%，不一致率为6%。