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术中细胞学涂片在脑肿瘤诊断中的评估，特别参考免疫组织化学

Evaluation of Intraoperative Cytological Smears for Diagnosis of Brain Tumors with Special Reference to Immunohistochemistry.

作者信息

Sarkar Saurav, Sengupta Moumita, Datta Chhanda, Chatterjee Uttara, Ghosh Samarendra Nath

机构信息

Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

Department of Neurosurgery, Bangur Institute of Neuroscience, Kolkata, West Bengal, India.

出版信息

Indian J Med Paediatr Oncol. 2017 Jul-Sep;38(3):296-301. doi: 10.4103/ijmpo.ijmpo_28_16.

DOI:10.4103/ijmpo.ijmpo_28_16
PMID:29200677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5686970/
Abstract

CONTEXT

Brain tumors are heterogeneous group of benign and malignant tumors of glial, meningeal, neuronal, embryonal, and lymphoid origin. Rapid intraoperative diagnosis of the nature of the tumor helps the surgeon to plan the extent of surgery and modify it accordingly.

AIMS

(1) To establish the validity and reliability of squash cytology in the intraoperative diagnosis of brain tumors. (2) To correlate with histopathological report and immunohistochemistry (IHC) profile.

SETTINGS AND DESIGN

Prospective, observational study.

SUBJECTS AND METHODS

prospective, observational study was conducted in the Department of Pathology in collaboration with the Department of Neurosurgery of a tertiary care hospital. One hundred and seven patients with symptomatic or radiologically detected brain tumors were included in the study. Intraoperative squash smears were stained with hematoxylin and eosin and rapid papanicolaou stain. Cytological diagnosis was recorded and communicated to the surgeon. Cytological findings were corroborated with histological findings subsequently. GFAP, Ki-67, and ER-PR IHC were used as additional markers.

STATISTICAL ANALYSIS USED

Software used in statistical analysis of our study was MedCalc version 11.6 (Mariakerke, Belgium: MedCalc Software 2011).

RESULTS

A total of 107 cases were included in the study. Meningioma was the most common lesion. Overall sensitivity in our study to diagnose benign and malignant tumors was 94.7% and the specificity is 97.6% with positive and negative predictive value of 94.7% and 97.6%, respectively. Diagnostic accuracy was highest in pituitary adenoma.

CONCLUSIONS

The combination of meticulous evaluation of clinical, radiological, and cytological findings helps in accurate and rapid diagnosis of brain tumors.

摘要

背景

脑肿瘤是一组异质性的良性和恶性肿瘤，起源于神经胶质、脑膜、神经元、胚胎和淋巴组织。术中快速诊断肿瘤的性质有助于外科医生规划手术范围并相应地进行调整。

目的

（1）确立压片细胞学在脑肿瘤术中诊断中的有效性和可靠性。（2）与组织病理学报告及免疫组织化学（IHC）特征进行对比。

设置与设计

前瞻性观察性研究。

对象与方法

在一家三级医疗医院的病理科与神经外科合作下进行了一项前瞻性观察性研究。107例有症状或经影像学检查发现脑肿瘤的患者纳入研究。术中压片涂片用苏木精和伊红染色以及快速巴氏染色。记录细胞学诊断结果并告知外科医生。随后将细胞学检查结果与组织学检查结果进行对照。使用胶质纤维酸性蛋白（GFAP）、Ki-67和雌激素受体-孕激素受体（ER-PR）免疫组织化学作为辅助标记物。

所用统计分析方法

本研究统计分析使用的软件是MedCalc版本11.6（比利时马里亚克：MedCalc软件公司，2011年）。

结果

本研究共纳入107例病例。脑膜瘤是最常见的病变。本研究中诊断良性和恶性肿瘤的总体敏感性为94.7%，特异性为97.6%，阳性预测值和阴性预测值分别为94.7%和97.6%。垂体腺瘤的诊断准确性最高。

结论

综合细致评估临床、影像学和细胞学检查结果有助于准确、快速地诊断脑肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/2b1550f7cca6/IJMPO-38-296-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/616dfe64b316/IJMPO-38-296-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/8e97eaab9548/IJMPO-38-296-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/f7925d9c23f5/IJMPO-38-296-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/7754ddc56bd1/IJMPO-38-296-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/5fa9b62a8e16/IJMPO-38-296-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/97cbd2b6fb5b/IJMPO-38-296-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/1a7f7398dc42/IJMPO-38-296-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/2b1550f7cca6/IJMPO-38-296-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/616dfe64b316/IJMPO-38-296-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/8e97eaab9548/IJMPO-38-296-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/f7925d9c23f5/IJMPO-38-296-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/7754ddc56bd1/IJMPO-38-296-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/5fa9b62a8e16/IJMPO-38-296-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/97cbd2b6fb5b/IJMPO-38-296-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/1a7f7398dc42/IJMPO-38-296-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de9/5686970/2b1550f7cca6/IJMPO-38-296-g012.jpg

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