Inuganti Renuka Venkata, Mettu Rami Reddy, Surath Harsha Vardhan, Surath Amarnath
Address: Department of Pathology and Orthopedics, NRI Medical College, Guntur, Andhra Pradesh, India.
Cytojournal. 2016 May 25;13:11. doi: 10.4103/1742-6413.182954. eCollection 2016.
To assess the adequacy of intraoperative scrape cytology during percutaneous vertebroplasty by correlating results with corresponding histopathology.
Vertebroplasty is a procedure increasingly used to treat painful vertebral compression fractures. The history and presentation of osteoporotic fractures are straightforward, but difficulty arises in differentiating infective from neoplastic lesions, especially in cases where the magnetic resonance imaging is equivocal. The procedure involves injection of polymethyl methacrylate (bone cement) into the pathological vertebral body and gives dramatic pain relief. It is indicated in osteoporotic and neoplastic lesions but contraindicated in infections. Hence, intraoperative evaluation of a specimen is essential to aid in the decision of performing vertebroplasty.
A total of 128 patients with vertebral lesions underwent core biopsy and scrape cytology from June 2006 to June 2015. Based on the findings of cytological examination, malignant lesions were subjected to vertebroplasty. In lesions with infective etiology, vertebroplasty was abandoned and antibiotic or antituberculous therapy started.
The overall diagnostic accuracy of scrape cytology was excellent with 97.58% cases correlating with the final histopathological diagnosis. Specificity was 100%, positive predictive value was 100% and negative predictive value was 33.33%.
Scrape cytology is a simple, rapid, accurate cytodiagnostic technique and should be routinely utilized in vertebral lesions for intraoperative consultation and decision making during vertebroplasty.
通过将术中刮片细胞学检查结果与相应的组织病理学结果进行关联，评估经皮椎体成形术中术中刮片细胞学检查的充分性。
椎体成形术是一种越来越多地用于治疗疼痛性椎体压缩骨折的手术。骨质疏松性骨折的病史和表现较为直接，但在区分感染性病变和肿瘤性病变时存在困难，尤其是在磁共振成像结果不明确的情况下。该手术包括将聚甲基丙烯酸甲酯（骨水泥）注入病理性椎体，可显著缓解疼痛。适用于骨质疏松性和肿瘤性病变，但不适用于感染性病变。因此，术中对标本进行评估对于辅助决定是否进行椎体成形术至关重要。
2006年6月至2015年6月，共有128例椎体病变患者接受了芯针活检和刮片细胞学检查。根据细胞学检查结果，对恶性病变进行椎体成形术。对于病因是感染的病变，放弃椎体成形术并开始使用抗生素或抗结核治疗。
刮片细胞学检查的总体诊断准确性极佳，97.58%的病例与最终组织病理学诊断相符。特异性为100%，阳性预测值为100%，阴性预测值为33.33%。
刮片细胞学检查是一种简单、快速、准确的细胞诊断技术，在椎体病变中应常规用于椎体成形术中术中和决策的咨询。
