Maurya Malti K, Yadav Rita, Kumar Madhu, Singh Hitendra P, Mishra Anand, Goel Madhu Mati
Department of Pathology, King George's Medical University, Lucknow, IND.
Department of Pathology, Prasad Institute of Medical Sciences, Lucknow, IND.
Cureus. 2023 Sep 16;15(9):e45353. doi: 10.7759/cureus.45353. eCollection 2023 Sep.
Background Palpable nodules in the thyroid are present in 4-7% of the general population. Fine-needle aspiration cytology is a safe and cost-effective method of choice for evaluating thyroid nodules. Aspirated samples can be manually spread directly onto the slide and stained in the conventional smear method. The liquid-cased cytology method has been recently introduced, which is an automated machine-based method, yielding a single slide with a clean background and greater preservation of cells and consuming less time for screening. This study aimed to compare the cytomorphological features and diagnostic accuracy of conventional smears and liquid-based cytology smears. Methodology This prospective study comprised 250 cases of thyroid lesions. Fine-needle aspiration cytology using conventional smears and liquid-based cytology smears was reported per the Bethesda system of reporting thyroid cytopathology. Detailed cytomorphological features were evaluated and compared in both techniques. Results The cellularity of conventional smears was significantly higher for scores 2+ and 3+ than paired liquid-based cytology smears (paired t-test, p < 0.001). The overall diagnostic efficacy of conventional smears and liquid-based cytology smears was equivalent in the majority of cases (n = 171, 68.4%). Conventional smears were better than liquid-cased cytology smears in 34 (13.6%) cases, and liquid-based cytology smears were better than conventional smears in eight (3.2%) cases. Liquid-based cytology smears showed a higher unsatisfactory rate compared to conventional Smears (15.6% vs. 5.2%). The sensitivity and specificity of conventional smears were 84.6% and 94.4%, respectively, compared to 68.7% and 92.4%, respectively, of liquid-based cytology smears. Conclusions Conventional smears are a cost-effective and easy method for diagnosing thyroid nodules. Liquid-based cytology smears can be used in association with conventional smears to enhance the accuracy of the evaluation of malignant thyroid nodules.
普通人群中4%-7%的人甲状腺可触及结节。细针穿刺细胞学检查是评估甲状腺结节的一种安全且经济有效的首选方法。吸出的样本可直接手工涂片于载玻片上，并采用传统涂片法染色。最近引入了液基细胞学方法，这是一种基于自动化机器的方法，可产生背景干净、细胞保存更好且筛查耗时更少的单张涂片。本研究旨在比较传统涂片和液基细胞学涂片的细胞形态学特征及诊断准确性。
本前瞻性研究纳入250例甲状腺病变病例。根据甲状腺细胞病理学报告的贝塞斯达系统报告采用传统涂片和液基细胞学涂片的细针穿刺细胞学检查结果。对两种技术的详细细胞形态学特征进行评估和比较。
对于2+和3+级，传统涂片的细胞密度显著高于配对的液基细胞学涂片（配对t检验，p<0.001）。在大多数病例（n = 171，68.4%）中，传统涂片和液基细胞学涂片的总体诊断效能相当。传统涂片在34例（13.6%）病例中优于液基细胞学涂片，液基细胞学涂片在8例（3.2%）病例中优于传统涂片。与传统涂片相比，液基细胞学涂片的不满意率更高（15.6%对5.2%）。传统涂片的敏感性和特异性分别为84.6%和94.4%，而液基细胞学涂片分别为68.7%和92.4%。
传统涂片是诊断甲状腺结节的一种经济有效且简便的方法。液基细胞学涂片可与传统涂片联合使用，以提高甲状腺恶性结节评估的准确性。
