Pilotti S, Rilke F, Claren R, Milella M, Lombardi L
Division of Pathology and Cytology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Acta Cytol. 1988 Jan-Feb;32(1):27-38.
A study of the diagnosis of hepatic and pancreatic malignancies by fine needle aspiration (FNA) was made, based on 221 aspirates obtained from 209 patients with histologic or clinical confirmation: 159 with hepatic and 50 with pancreatic lesions. The values of sensitivity, specificity and predictivity for positive FNA results were, respectively, 0.84, 0.96 and 1.0 for the liver and 0.76, 1.0 and 1.0 for the pancreas. The composition of the case material showed an incidence of malignant tumors of the liver and pancreas of 84% and 60%, respectively (among which the primary malignancies were 39% and 48%), while nonneoplastic lesions had incidences of 14% and 40%. However, conclusive FNA diagnoses of the histologic type of the primary and the site of origin of metastatic tumors were made in 60% of the hepatic lesions but in only 9% of the pancreatic lesions. Primary hepatocellular carcinoma was diagnosed by FNA of the liver in 95% of the cases; FNA specifically diagnosed 42% of intrahepatic bile duct carcinomas and 40% of hepatic metastases. These findings correlate with the unique cytologic features of primary hepatocellular carcinoma of intrahepatic rather nonspecific morphology of carcinoma of intrahepatic and extrahepatic origin, as well as of pancreatic ductal origin.
基于从209例经组织学或临床确诊的患者获取的221份细针穿刺抽吸物（FNA），对肝和胰腺恶性肿瘤的诊断进行了一项研究：其中159例为肝脏病变，50例为胰腺病变。肝脏FNA阳性结果的敏感性、特异性和预测值分别为0.84、0.96和1.0，胰腺的则分别为0.76、1.0和1.0。病例材料的构成显示，肝脏和胰腺恶性肿瘤的发生率分别为84%和60%（其中原发性恶性肿瘤分别为39%和48%），而非肿瘤性病变的发生率分别为14%和40%。然而，在60%的肝脏病变中FNA做出了原发性组织学类型和转移瘤起源部位的确切诊断，但在胰腺病变中仅为9%。肝脏FNA诊断出95%的原发性肝细胞癌；FNA特异性诊断出42%的肝内胆管癌和40%的肝转移瘤。这些发现与原发性肝细胞癌独特的细胞学特征相关，肝内癌的形态而非肝内和肝外起源以及胰腺导管起源的癌的非特异性形态。
