Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
Department of Oral Surgery and Pathology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Diagn Cytopathol. 2020 Aug;48(8):717-723. doi: 10.1002/dc.24400. Epub 2020 Feb 29.
The cell-block technique is a cytological diagnostic method that decreases cellular dispersion; however, its usefulness regarding intraosseous lesions is underexplored. Therefore, this study aimed to assess the diagnostic usefulness of cell-block for cystic and cyst-like jaw lesions.
Individuals with cystic or cyst-like jaw lesions who underwent aspiration biopsy were considered eligible. Aspiration of luminal content was prepared and processed by the cell-block technique. Cytological evaluations were blindly performed by two trained PhD students (in a single evaluation) and one oral and maxillofacial pathologist (OMP). Cohen's kappa statistic was used to measure inter-rater agreement.
The sample was composed of 52 lesions, represented by 25 radicular cysts (RC), 17 odontogenic keratocysts (OKC), 5 idiopathic bone cavities (IBC), and 5 unicystic ameloblastomas (UA). The kappa coefficient of cell-block compared to histopathological diagnosis was 0.390 (95% confidence interval [95%CI], 0.195-0.585) for PhD students and 0.612 (95%CI, 0.433-0.791) for the OMP. The highest concordance rates between cell-block and histopathological diagnosis were observed for RC (PhD = 76.0%; OMP = 80.0%) and OKC (PhD = 58.8%; OMP = 76.5%). Conflicting results were found regarding IBC (PhD = 40.0%; OMP = 80.0%) and UA, that presented the overall lowest concordance rates (PhD = 20.0%; OMP = 40.0%).
The cell-block technique presented a high diagnostic usefulness for detecting RC and OKC and, if associated with clinical and radiographic characteristics, might be sufficient for final diagnosis of these diseases. Regarding IBC and UA, an analysis with a higher number of cases is recommended to determine the true usefulness of the cell-block as ancillary tool for the diagnosis of these lesions.
细胞块技术是一种减少细胞分散的细胞学诊断方法，但关于骨内病变的应用尚未得到充分探索。因此，本研究旨在评估细胞块在囊性和囊性颌骨病变中的诊断价值。
纳入接受囊腔抽吸活检的囊性或囊性颌骨病变患者。对管腔内容物进行抽吸并通过细胞块技术进行处理。两名经过培训的博士研究生（单次评估）和一名口腔颌面病理学家（OMP）对细胞学评估进行盲法评估。采用 Cohen's kappa 统计量来衡量评估者间的一致性。
样本由 52 个病变组成，包括 25 个根尖囊肿（RC）、17 个牙源性角化囊肿（OKC）、5 个特发性骨腔（IBC）和 5 个单囊型成釉细胞瘤（UA）。细胞块与组织病理学诊断的 kappa 系数为博士研究生 0.390（95%置信区间 [95%CI]，0.195-0.585），OMP 为 0.612（95%CI，0.433-0.791）。RC（博士研究生 = 76.0%；OMP = 80.0%）和 OKC（博士研究生 = 58.8%；OMP = 76.5%）的细胞块与组织病理学诊断的一致性最高。IBC（博士研究生 = 40.0%；OMP = 80.0%）和 UA 的结果存在争议，一致性最低（博士研究生 = 20.0%；OMP = 40.0%）。
细胞块技术对于检测 RC 和 OKC 具有较高的诊断价值，如果结合临床和影像学特征，可能足以对这些疾病做出最终诊断。对于 IBC 和 UA，建议进行更多病例的分析，以确定细胞块作为这些病变辅助诊断工具的真正价值。
