Philip Shilpa Accamma, Bai Earla Lakshmi, Padmaja G J Vani, Kumari Swarajya
Department of Pathology, Osmania Medical College, Hyderabad, Telangana, India.
J Cytol. 2023 Jan-Mar;40(1):1-4. doi: 10.4103/joc.joc_70_22. Epub 2023 Jan 17.
Central nervous system lesions are diverse and remain one of the most challenging domains for neuropathologists. Intraoperative cytological diagnosis is now a universally accepted technique in diagnosis of central nervous system (CNS) lesions.
Prospective study conducted at a tertiary healthcare centre over a period of two years.
All biopsy materials which underwent squash cytology and histopathological examination were collected, evaluated, classified, and graded according to WHO classification of CNS Tumors, 2016. The squash cytosmear diagnosis was compared with histopathological features and radiological diagnosis. Discordances were evaluated.
The cases were categorized into true positives, false positives, true negatives, and false negatives. Diagnostic accuracy, sensitivity, and specificity were calculated from 2*2 table.
A total of 190 cases were included in the study. A total of 182 cases (95.70%) were neoplastic of which 87.36% were primary CNS neoplasms. Diagnostic accuracy in non-neoplastic lesions was 88.8%. Most common neoplastic lesions were glial tumors (35.7%), meningioma (17.3%), tumors of cranial and spinal nerves (12%), and metastatic lesions (12%). Diagnostic accuracy of squash cytology was higher in glial tumors (93.8%), meningioma (96.7%), and metastatic lesions (95.45%). Diagnostic accuracy of radiological modalities was 85.78%.
A good familiarity with cytomorphological features of CNS lesions, clinical details, radiological findings, and intraoperative impression of neurosurgeon enables the pathologist to improve diagnostic accuracy and reduce errors.
中枢神经系统病变多种多样，仍然是神经病理学家面临的最具挑战性的领域之一。术中细胞学诊断现已成为中枢神经系统（CNS）病变诊断中普遍接受的技术。
1）分析并比较术中压片涂片中枢神经系统病变的细胞形态学特征与组织病理学、免疫组化及术前影像学诊断；2）确定术中压片细胞学的诊断准确性、敏感性和特异性。
在一家三级医疗中心进行的为期两年的前瞻性研究。
收集所有接受压片细胞学和组织病理学检查的活检材料，根据2016年世界卫生组织中枢神经系统肿瘤分类进行评估、分类和分级。将压片细胞涂片诊断与组织病理学特征及影像学诊断进行比较。评估不一致情况。
将病例分为真阳性、假阳性、真阴性和假阴性。根据2×2表格计算诊断准确性、敏感性和特异性。
本研究共纳入190例病例。共有182例（95.70%）为肿瘤性病变，其中87.36%为原发性中枢神经系统肿瘤。非肿瘤性病变的诊断准确性为88.8%。最常见的肿瘤性病变为神经胶质瘤（35.7%）、脑膜瘤（17.3%）、颅神经和脊神经肿瘤（12%）以及转移性病变（12%）。神经胶质瘤（93.8%）、脑膜瘤（96.7%）和转移性病变（95.45%）的压片细胞学诊断准确性较高。影像学检查方法的诊断准确性为85.78%。
熟悉中枢神经系统病变的细胞形态学特征、临床细节、影像学表现及神经外科医生的术中印象，有助于病理学家提高诊断准确性并减少错误。
