Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Indian J Pathol Microbiol. 2020 Oct-Dec;63(4):581-586. doi: 10.4103/IJPM.IJPM_999_19.
Although liquid-based cytology (LBC) has gained popularity among clinical laboratories, it is unclear whether it is equivalent to conventional smears for making a definite diagnosis of papillary thyroid carcinoma (PTC). The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) suggests a definite diagnosis of PTC is preferred when there are at least one of three features (papillary architecture, psammomatous calcifications, and frequent pseudonuclear inclusions) plus other typical cytomorphological findings. This study evaluated whether an additional cell block (CB), prepared from the residual LBC material, could help improve the diagnosis of PTC.
A total of 62 cases with both ThinPrep LBC and CB preparations and histopathological follow-up of PTC were retrieved between November 2016 and March 2019. The ThinPrep LBC and CB slides were reviewed separately to identify any papillary architecture, psammomatous calcifications, or pseudonuclear inclusions for diagnosing PTC.
Among the 51 cases with cytological diagnosis of PTC in the LBC+CB slides, the CB provided additional diagnostic information in 15 cases, which were initially diagnosed as suspicious for PTC based on the LBC slides alone. This information included papillary architecture (n=11), psammomatous calcification (n=1) and pseudonuclear inclusions (n=5). The number of specimens in the 51 cases containing at least one of the three features increased from 42 (LBC) to 51 (LBC+CB). The accuracy for diagnosing PTC increased from 58.1% for LBC alone to 82.3% for the LBC+CB examination.
An adjunctive CB preparation may improve the LBC technique for diagnosing PTC.
虽然液基细胞学（LBC）在临床实验室中越来越受欢迎，但尚不清楚其是否与传统涂片一样能够明确诊断甲状腺乳头状癌（PTC）。《甲状腺细胞病理学报告的 Bethesda 系统（TBSRTC）》建议，当存在至少三种特征之一（乳头状结构、砂粒体样钙化和频繁出现假核内包涵体）加上其他典型的细胞学形态特征时，首选明确诊断为 PTC。本研究评估了从剩余的 LBC 材料中制备的额外细胞块（CB）是否有助于提高 PTC 的诊断。
回顾性收集了 2016 年 11 月至 2019 年 3 月间共有 62 例同时进行了 ThinPrep LBC 和 CB 制片且具有 PTC 组织学随访的病例。单独观察 ThinPrep LBC 和 CB 切片，以识别任何乳头状结构、砂粒体样钙化或假核内包涵体，用于诊断 PTC。
在 LBC+CB 切片细胞学诊断为 PTC 的 51 例中，CB 为 15 例提供了额外的诊断信息，这些病例单独根据 LBC 切片诊断为 PTC 可疑。这些信息包括乳头状结构（n=11）、砂粒体样钙化（n=1）和假核内包涵体（n=5）。51 例中至少包含三种特征之一的标本数量从 LBC 的 42 例增加到 LBC+CB 的 51 例。单独使用 LBC 诊断 PTC 的准确率为 58.1%，而 LBC+CB 检查的准确率为 82.3%。
辅助 CB 制片可能会提高 LBC 技术对 PTC 的诊断。
