Department of Pathology, Emory University Hospital, Atlanta, Georgia.
Department of Pathology, Moffit Cancer Center, Tampa, Florida.
Cancer Cytopathol. 2021 Apr;129(4):283-290. doi: 10.1002/cncy.22378. Epub 2020 Nov 2.
Although 10% formalin is a standard preservative in pancreatic FNAs, the effect of CytoLyt on pancreatic tissue preservation has not been systematically explored.
Smears and cell blocks from CytoLyt-fixed (CF-CBs) and formalin-fixed (FF-CBs) pancreatic FNAs were blindly reviewed without knowledge of the fixative used, and the presence of tissue/tumor autolysis was noted. Controls included FF-CBs from pancreatic FNAs, CF-CBs from nonpancreatic FNAs, and 4 pancreatic FNAs with matched CF-CBs and FF-CBs.
We found that 62 of 85 (73%) pancreatic FNAs with CF-CBs showed significant autolysis, which was most pronounced in acinar cells and/or tumor cells with benign acinar cells in the background, compared with 2 of 46 (4%) FF-CBs (P < .0001) and 3 of 26 (12%) CF-CBs from nonpancreatic FNAs (73% vs 12%; P < .0001). Of the 4 pancreatic FNAs with matched CF-CBs and FF-CBs, all 4 CF-CBs showed marked autolysis versus none of the matched FF-CBs. Of the 23 (27%) pancreatic FNAs with CF-CBs that did not show autolysis, 10 had no acinar cells, and 7 had only minute tissue fragments on CB.
While CytoLyt is a useful fixative for nonpancreatic FNAs it is a suboptimal fixative for pancreatic FNAs and is associated with tissue/tumor autolysis in the majority of cases, influencing morphologic evaluation, and potentially immunocytochemical staining. Autolysis appears to be due to acinar enzymes whose effect is likely interrupted/inhibited by formalin fixation. Cytopathologists and cytotechnologists should be mindful of this pitfall and should avoid using CytoLyt as a fixative for pancreatic FNAs.
虽然 10%福尔马林是胰腺细针抽吸术（FNAs）的标准防腐剂，但 CytoLyt 对胰腺组织保存的影响尚未得到系统探索。
盲法阅片并评估 CytoLyt 固定（CF-CBs）和福尔马林固定（FF-CBs）的胰腺 FNA 涂片和细胞块，且不了解固定剂的使用情况，并注意组织/肿瘤自溶的存在。对照组包括来自胰腺 FNA 的 FF-CBs、来自非胰腺 FNA 的 CF-CBs 以及 4 例具有匹配 CF-CBs 和 FF-CBs 的胰腺 FNA。
我们发现，62 例（73%）CF-CBs 胰腺 FNA 显示明显的自溶，与 4 例 FF-CBs（4%）相比，背景中良性腺泡细胞中的腺泡细胞和/或肿瘤细胞最为明显（P <.0001），与 26 例（12%）来自非胰腺 FNA 的 CF-CBs 相比（73% vs 12%；P <.0001）。在 4 例具有匹配 CF-CBs 和 FF-CBs 的胰腺 FNA 中，所有 4 例 CF-CBs 均显示明显的自溶，而相应的 FF-CBs 均无。在 23 例（27%）无自溶的 CF-CBs 胰腺 FNA 中，10 例无腺泡细胞，7 例 CB 上仅有微小的组织碎片。
虽然 CytoLyt 是一种有用的非胰腺 FNA 固定剂，但它是一种不理想的胰腺 FNA 固定剂，在大多数情况下与组织/肿瘤自溶相关，影响形态学评估，并且可能影响免疫细胞化学染色。自溶似乎是由于腺泡酶引起的，福尔马林固定可能会中断/抑制这些酶的作用。细胞病理学家和细胞技术专家应注意到这一陷阱，并应避免将 CytoLyt 用作胰腺 FNA 的固定剂。
