Khuroo Mehnaaz Sultan, Mushtaq Shaista, Farooq Summyia, Beigh Ambreen, Nazir Naila, Reshi Ruby
Assistant Professor, Department of Pathology, Government Medical College , Srinagar, Jammu and Kashmir, India .
Senior Resident, Department of Pathology, Government Medical College , Srinagar, Jammu and Kashmir, India .
J Clin Diagn Res. 2016 Oct;10(10):EC13-EC17. doi: 10.7860/JCDR/2016/21929.8732. Epub 2016 Oct 1.
Scrape cytology is an important diagnostic tool. It has been used in many tissue types as an adjunct or replacement for frozen section/ intra operative consultation.
This study was done to evaluate the role of scrape cytology in the diagnosis of thyroid lesions, its role as an adjunct to Fine Needle Aspiration Cytology (FNAC) and application of this technique for intra-operative consultation.
A prospective study on 50 thyroid neoplasms received over a period of 18 months (Nov 2014- March 2016) was conducted. Scrapings obtained from the fresh cut surface of thyroid specimens before formalin fixation, were smeared uniformly on to glass slides, and immediately fixed in 95% ethyl alcohol for rapid Haematoxylin and Eosin (H&E). Cytological findings were compared with pre-operative FNAC findings and histopathological diagnosis. Variables taken in to consideration while assessing the smears included cellularity, nuclear, cytological details and amount of colloid.
There were total of 50 patients. Out of the 50 patients, 15 were diagnosed as benign on scrape; of which 100% of cases were true negative for malignancy and five malignant cases were diagnosed as benign-false negative rate of 16.1%; four (8%) were deferred (non-diagnostic) with a true positive rate of 83.3%. Histopathological correlation was available in all cases. The overall diagnostic accuracy of scrape cytology was 89.1% with sensitivity and specificity of 83.87% (C.I.; 66.27% to 94.55%) and 100% (C.I; 76.84% to 100.00%) respectively. Fine Needle Aspiration results were available in 41 cases of which 2 were non-diagnostic. Of the remaining 39 cases 19 were benign and 20 were malignant with false negative rate of 40% and true positive rate of 60%. The overall diagnostic accuracy of FNAC was 64.1% with sensitivity and specificity of 60% (C.I.; 40.6% to77.3 %) and 77.78% (C.I; 39.9% to 97.1%) respectively.
We conclude that scrape cytology can act as a useful adjunct to FNAC and is a good procedure for intra-operative consultation. It is especially helpful in neoplasms diagnosed as suspicious for papillary carcinoma on aspiration and may obviate the need for a second procedure for completion thyroidectomy.
刮片细胞学是一种重要的诊断工具。它已被用于多种组织类型，作为冰冻切片/术中会诊的辅助手段或替代方法。
本研究旨在评估刮片细胞学在甲状腺病变诊断中的作用、其作为细针穿刺抽吸细胞学检查（FNAC）辅助手段的作用以及该技术在术中会诊中的应用。
对在18个月（2014年11月至2016年3月）期间接收的50例甲状腺肿瘤进行了一项前瞻性研究。在福尔马林固定前，从甲状腺标本的新鲜切面获取刮片，均匀涂抹在载玻片上，立即用95%乙醇固定，以便快速进行苏木精和伊红（H&E）染色。将细胞学检查结果与术前FNAC结果及组织病理学诊断进行比较。评估涂片时考虑的变量包括细胞密度、细胞核、细胞学细节和胶质含量。
共有50例患者。在这50例患者中，15例经刮片诊断为良性；其中100%的病例恶性为真阴性，5例恶性病例被诊断为良性，假阴性率为16.1%；4例（8%）结果不确定（无法诊断），真阳性率为83.3%。所有病例均有组织病理学相关性。刮片细胞学的总体诊断准确率为89.1%，敏感性和特异性分别为83.87%（置信区间；66.27%至94.55%）和100%（置信区间；76.84%至100.00%）。41例患者有细针穿刺抽吸结果，其中2例无法诊断。在其余39例中，19例为良性，20例为恶性，假阴性率为40%，真阳性率为60%。FNAC的总体诊断准确率为64.1%，敏感性和特异性分别为60%（置信区间；40.6%至77.3%）和77.78%（置信区间；39.9%至97.1%）。
我们得出结论，刮片细胞学可作为FNAC的有用辅助手段，并且是术中会诊的良好方法。它在穿刺诊断为可疑乳头状癌的肿瘤中特别有帮助，可能无需进行二次手术来完成甲状腺切除术。
