液基细胞学（LBC）是否应应用于甲状腺细针穿刺细胞学样本？传统涂片与LBC涂片的对比分析。

Should Liquid Based Cytology (LBC) be Applied to Thyroid Fine Needle Aspiration Cytology Samples?: Comparative Analysis of Conventional and LBC Smears.

作者信息

Mahajan Swati, Rajwanshi Arvind, Srinivasan Radhika, Radotra Bishan Dass, Panda Naresh

机构信息

Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J Cytol. 2021 Oct-Dec;38(4):198-202. doi: 10.4103/JOC.JOC_6_17. Epub 2021 Nov 12.

DOI:10.4103/JOC.JOC_6_17

PMID:35002112

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8670454/

Abstract

CONTEXT

Liquid-based cytology (LBC) is a cyto-preparatory technique that may be applied to fine-needle aspiration (FNA) samples. However, its efficacy over conventional smears (CS) in thyroid is controversial.

AIMS

The aim of this study was to compare CS versus LBC (SurePath, BD) preparations in thyroid FNA samples for diagnostic efficacy.

SETTINGS AND DESIGN

Prospective case-control study using split sample analysis in 200 non-consecutive cases of thyroid FNA reported as per the Bethesda system.

METHODS AND MATERIAL

Detailed cytomorphological features were evaluated in CS and LBC preparations. Cellularity was scored as 0-3. Based on diagnostic efficacy, they were categorized into three groups:(i) CS and LBC equivalent for diagnosis, (ii) CS better than LBC, and (iii) LBC better than CS for providing the diagnosis.

STATISTICAL ANALYSIS USED

Paired t test for cellularity scores and descriptive for diagnostic efficacy.

RESULTS

There were 7 unsatisfactory, 118 benign, 10 atypia or follicular lesion of undetermined significance, 25 follicular neoplasms, 6 suspicious for malignancy, and 34 malignant thyroid FNA cases based on routine conventional smears. Cellularity of conventional smears was significantly higher than paired LBC smears (paired t test, < 0.005). Comparison of overall diagnostic efficacy showed that LBC and CS were equivalent in 59% of cases; CS was superior to LBC in 37% cases and LBC was better than CS in 4% cases only. LBC smears showed higher unsatisfactory rate as compared to CS (18% vs. 3.5%). In category 2, the two techniques were equivalent in 87% of cases. In categories 4 and 6, CS were superior to LBC.

CONCLUSIONS

In thyroid FNA cases, conventional smears are superior to LBC preparation in terms of cellularity and diagnostic efficacy and hence, LBC preparations should not replace conventional smears for making a routine cytomorphological diagnosis.

摘要

背景

液基细胞学检查（LBC）是一种可应用于细针穿刺抽吸（FNA）样本的细胞制备技术。然而，其在甲状腺检查中相对于传统涂片（CS）的效果存在争议。

目的

本研究旨在比较甲状腺FNA样本中CS与LBC（SurePath，BD）制备方法的诊断效果。

设置与设计

采用前瞻性病例对照研究，对200例非连续的甲状腺FNA病例进行拆分样本分析，病例报告采用贝塞斯达系统。

方法与材料

对CS和LBC制备样本的详细细胞形态学特征进行评估。细胞密度评分为0 - 3分。根据诊断效果，将其分为三组：（i）CS和LBC诊断效果相当；（ii）CS优于LBC；（iii）LBC优于CS。

所用统计分析方法

细胞密度评分采用配对t检验，诊断效果采用描述性统计。

结果

根据常规传统涂片，有7例不满意样本，118例良性样本，10例非典型或意义未明的滤泡性病变，25例滤泡性肿瘤，6例可疑恶性肿瘤，以及34例恶性甲状腺FNA病例。传统涂片的细胞密度显著高于配对的LBC涂片（配对t检验，<0.005）。总体诊断效果比较显示，59%的病例中LBC和CS相当；37%的病例中CS优于LBC，仅4%的病例中LBC优于CS。与CS相比，LBC涂片的不满意率更高（18%对3.5%）。在2类病例中，两种技术在87%的病例中相当。在4类和6类病例中，CS优于LBC。