Sarkar Aniruddha, Sharma Nishi, Sharma Shweta
Ent Department, Dr. Ram Manohar Lohia Hospital, New Delhi, Delhi India.
Indian J Otolaryngol Head Neck Surg. 2017 Jun;69(2):147-154. doi: 10.1007/s12070-016-0982-4. Epub 2016 May 9.
We aimed to improve the diagnostic accuracy of tumors by using immunocytochemistry (IHC) on destained smears to correlate the cytological findings with histopathology and/or IHC for final evaluation of results. We have done a randomized and prospective double-blind study. Forty-six clinically suspected patients of salivary gland tumor were enrolled for study. Those with non-neoplastic\ inflammatory salivary gland pathologies and swellings other than salivary gland origin were excluded from the study. The Fine needle aspiration cytological (FNAC) diagnosis of all the patients was compared with the corresponding histopathology. Sensitivity and specificity of FNAC in diagnosing malignancy were 91.3 and 100 %. Diagnostic accuracy of FNAC for malignant tumors was 95.65 %. In our study kappa value came out to be 0.88 ( value <0.00), which indicated an excellent agreement between histological and cytological typing of salivary gland tumors. FNAC is a highly sensitive and specific technique for diagnosis of salivary gland tumors. Histopathology however is the gold standard for diagnosis, classification and grading of tumors. Immuno-cytochemistry can act as adjuvant in diagnosing salivary gland tumors, however it did not help in improving the diagnostic accuracy of FNAC in our study. Considering an excellent agreement between cytology and histology, a type specific diagnosis can be reached on FNAC of salivary gland tumors.
我们旨在通过对脱色涂片进行免疫细胞化学(IHC)来提高肿瘤的诊断准确性,以便将细胞学检查结果与组织病理学和/或免疫细胞化学结果相关联,从而对结果进行最终评估。我们进行了一项随机前瞻性双盲研究。46例临床怀疑为涎腺肿瘤的患者被纳入研究。那些患有非肿瘤性/炎性涎腺病变以及非涎腺来源肿胀的患者被排除在研究之外。将所有患者的细针穿刺细胞学(FNAC)诊断结果与相应的组织病理学结果进行比较。FNAC诊断恶性肿瘤的敏感性和特异性分别为91.3%和100%。FNAC对恶性肿瘤的诊断准确性为95.65%。在我们的研究中,kappa值为0.88(p值<0.00),这表明涎腺肿瘤的组织学和细胞学分型之间具有极好的一致性。FNAC是诊断涎腺肿瘤的一种高度敏感和特异的技术。然而,组织病理学是肿瘤诊断、分类和分级的金标准。免疫细胞化学可作为诊断涎腺肿瘤的辅助手段,但在我们的研究中,它无助于提高FNAC的诊断准确性。考虑到细胞学和组织学之间的极好一致性,通过涎腺肿瘤的FNAC可以得出特定类型的诊断。