Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, Lagos, Nigeria.
Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria.
Diagn Cytopathol. 2020 Dec;48(12):1300-1306. doi: 10.1002/dc.24576. Epub 2020 Aug 11.
Although fine needle aspiration cytology (FNAC) is highly accurate for detecting breast malignancies, concerns remain among cytopathologists about false-positive and false-negative diagnoses. Cell block (CB) preparations have been advocated by some cytopathologists as one of the methods to improve and consolidate the diagnostic accuracy of FNAC. The aim of this study was to determine the diagnostic utility of CB in FNAC of palpable breast lesions among female patients.
Following FNA, CBs were prepared using 10% neutral-buffered formalin from the residual breast aspirates of 100 consecutive female patients attending the FNAC clinic. The slides of the conventional smears, CB and excisional biopsies were examined, and results were analysed using the SPSS.
Of the 100 patients that had FNAC, 44 (44%) had excisional biopsy performed. An additional 13% diagnostic yield for malignancy was obtained with the use of CB preparations. CB reduced equivocal diagnoses by 25%, corresponding with 90.9% improvement on definitive diagnoses.
In our setting, the addition of CB to smear remarkably improved the diagnostic utility of breast FNAC by minimising atypical and suspicious for malignancy diagnostic categories.
虽然细针穿刺细胞学（FNAC）在检测乳腺癌方面具有高度准确性，但细胞病理学家仍对假阳性和假阴性诊断存在担忧。一些细胞病理学家提倡使用细胞块（CB）制备作为提高和巩固 FNAC 诊断准确性的方法之一。本研究旨在确定 CB 在女性患者可触及乳腺病变的 FNAC 中的诊断效用。
在进行 FNA 后，使用 10%中性缓冲福尔马林从 100 例连续女性 FNAC 诊所患者的剩余乳腺抽吸物中制备 CB。检查常规涂片、CB 和切除活检的载玻片，并使用 SPSS 进行分析。
在进行 FNAC 的 100 例患者中，有 44 例（44%）进行了切除活检。使用 CB 制备可额外获得 13%的恶性肿瘤诊断率。CB 将不确定的诊断减少了 25%，明确诊断的改善率为 90.9%。
在我们的环境中，通过最小化恶性肿瘤的非典型和可疑诊断类别，将 CB 添加到涂片可显著提高乳腺 FNAC 的诊断效用。
