Chaurasia Jai K, Ilyas Abeer M, Walke Vaishali, Gupta Vikas, Kapoor Neelkamal
Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, IND.
Otorhinolaryngology, All India Institute of Medical Sciences, Bhopal, IND.
Cureus. 2023 Apr 20;15(4):e37872. doi: 10.7759/cureus.37872. eCollection 2023 Apr.
Introduction Fine needle aspiration cytology (FNAC) plays a vital role in the diagnosis of thyroid nodules. However, it is challenging due to the heterogeneity of thyroid nodules, overlapping cytomorphological features, and interobserver variability. Cytomorphometric analysis turns subjective observations into quantitative values. In this study, we performed cytomorphometric image analysis on cytological smears of thyroid nodules, classified according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Materials and methods A retrospective analysis of Papanicolaou (PAP) and Hematoxylin & Eosin (H&E) stained fine needle aspirate smears from 50 patients with thyroid nodules with available follow-up histopathology was performed for a period of two years (March 2021 - March 2023), after obtaining approval from the institutional human ethical committee (IHEC-LOP/2020/IM0355). The nodules were categorized according to TBSRTC and were then subjected to cytomorphometric image analysis. Each nucleus was analyzed for 14 parameters, including aspect ratio, intensity, diameter, perimeter, roundness, area, fractal dimension, feret diameter, circularity, radii, fournier description, and chromatin texture parameters such as heterogeneity and clumpiness. The data obtained was analyzed through relevant statistical methods using SPSS version 23 (IBM Inc., Armonk, New York) and was compared by using the analysis of variance (ANOVA) test and post hoc test. Results Our results revealed that cytomorphometric image analysis not only distinguishes benign and malignant thyroid nodules but also can aid in categorizing thyroid nodules with predominant follicular patterns, such as follicular variant of papillary carcinoma, follicular adenoma and follicular carcinoma (p<0.001). Conclusions Morphometric analysis of cytological smears combined with cytomorphology has the potential to be an important tool in the diagnosis of thyroid nodules. It can improve diagnostic accuracy for better treatment and improved prognosis.
引言 细针穿刺细胞学检查（FNAC）在甲状腺结节的诊断中起着至关重要的作用。然而，由于甲状腺结节的异质性、细胞形态学特征的重叠以及观察者间的差异，其具有挑战性。细胞形态计量分析将主观观察转化为定量值。在本研究中，我们对根据甲状腺细胞病理学报告贝塞斯达系统（TBSRTC）分类的甲状腺结节细胞学涂片进行了细胞形态计量图像分析。
材料与方法 在获得机构人类伦理委员会（IHEC-LOP/2020/IM0355）批准后，对50例有可用随访组织病理学结果的甲状腺结节患者的巴氏（PAP）和苏木精-伊红（H&E）染色的细针穿刺涂片进行了为期两年（2021年3月至2023年3月）的回顾性分析。结节根据TBSRTC进行分类，然后进行细胞形态计量图像分析。对每个细胞核分析14个参数，包括长宽比、强度、直径、周长、圆度、面积、分形维数、费雷特直径、圆形度、半径、傅里叶描述以及染色质纹理参数，如异质性和团块性。使用SPSS 23版（IBM公司，纽约州阿蒙克）通过相关统计方法对获得的数据进行分析，并使用方差分析（ANOVA）检验和事后检验进行比较。
结果 我们的结果表明，细胞形态计量图像分析不仅可以区分良性和恶性甲状腺结节，还可以帮助对具有主要滤泡模式的甲状腺结节进行分类，如乳头状癌滤泡变体、滤泡性腺瘤和滤泡癌（p<0.001）。
结论 细胞学涂片的形态计量分析与细胞形态学相结合有潜力成为甲状腺结节诊断的重要工具。它可以提高诊断准确性，以实现更好治疗和改善预后。
