Olson Matthew T, Novak Anna, Boonyaarunnate Thiraphon, Shahid Hinna, Kirby John, Ali Syed Z
Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, Maryland.
Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Am Soc Cytopathol. 2014 Mar-Apr;3(2):60-66. doi: 10.1016/j.jasc.2013.07.002. Epub 2013 Oct 21.
On-site evaluation of adequacy (OSEA) is commonly used to increase the adequacy rate of fine-needle aspiration (FNA) procedures. OSEA is increasingly necessary with the widespread use of image-guided procedures, which are expensive to perform and repeat. The increased demand for OSEA has prompted an increasing reliance on cytotechnologists for OSEA in many practices, including ours. However, the performance of cytotechnologists has not been compared with that of cytopathologists for OSEA in FNA of bone and soft tissue tumors.
We retrospectively analyzed 10 years of data in which both cytotechnologists and cytopathologists performed OSEA for 632 bone and soft tissue tumor FNA. We calculated adequacy and accuracy statistics in conjunction with other variables including imaging modality, biopsy site, accompanying core biopsy, tissue type, final diagnosis, and number of smears.
Of the 632 bone and soft tissue tumor FNA procedures, OSEA was performed in 223 (35.3%) by cytotechnologists and in 409 (64.7%) by cytopathologists. There was no difference in the adequacy downgrade rate for cytotechnologists versus cytopathologists during this study period (4.5 versus 2.4%, P = 0.23). The adequacy rates for procedures in which OSEA was performed by cytotechnologists and cytopathologists did not differ significantly (78.9 versus 84.1%, P = 0.13).
Cytotechnologists and cytopathologists are comparably accurate in OSEA of bone and soft tissue neoplasms.
现场充分性评估（OSEA）常用于提高细针穿刺活检（FNA）操作的充分率。随着影像引导操作的广泛应用，OSEA变得越来越必要，因为这类操作执行和重复的成本都很高。对OSEA需求的增加促使许多机构（包括我们的机构）越来越依赖细胞技术人员进行OSEA。然而，在骨与软组织肿瘤FNA的OSEA中，细胞技术人员与细胞病理学家的表现尚未得到比较。
我们回顾性分析了10年的数据，其中细胞技术人员和细胞病理学家都对632例骨与软组织肿瘤FNA进行了OSEA。我们结合其他变量计算了充分率和准确率统计数据，这些变量包括成像方式、活检部位、同期进行的粗针活检、组织类型、最终诊断以及涂片数量。
在632例骨与软组织肿瘤FNA操作中，细胞技术人员进行了223例（35.3%）的OSEA，细胞病理学家进行了409例（64.7%）。在本研究期间，细胞技术人员与细胞病理学家的充分率降级率没有差异（4.5%对2.4%，P = 0.23）。细胞技术人员和细胞病理学家进行OSEA的操作充分率没有显著差异（78.9%对84.1%，P = 0.13）。
在骨与软组织肿瘤的OSEA中，细胞技术人员和细胞病理学家的准确性相当。
