Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Diagn Cytopathol. 2024 Apr;52(4):217-224. doi: 10.1002/dc.25274. Epub 2024 Jan 12.
The two widely established systems for liquid-based cytology (LBC), ThinPrep and SurePath, employ different principles. The aim of this study was to compare the cytomorphology of thyroid lesions prepared by the two techniques.
We retrospectively reviewed 44 thyroid FNA specimens prepared by LBC, including 20 ThinPrep and 22 SurePath. Cytologic diagnoses were made according to the Bethesda system and cytomorphologic parameters were evaluated.
Acellular smears were significantly frequent in ThinPrep than SurePath (10% vs. 0%). Both techniques produced a clean background, well cell preservation, and not apparent cell shrinkage. ThinPrep showed significantly lower cellularity than SurePath (25% vs. 4.3%). ThinPrep produced considerable flattening and fragmented clusters, while SurePath contained larger clusters in a three-dimensional configuration. Colloid was significantly reduced in amount and fragmented in ThinPrep, and was easily observed in SurePath. In cases of Hashimoto's thyroiditis, ThinPrep produced much less leukocytes in background than SurePath. Aggregates of fibrin and leukocytes were frequently present in 10/16 cases (62.5%) processed by ThinPrep. Air-dry artifact at periphery of the ring was present in 6/16 cases (37.5%) processed by ThinPrep. The nuclear features of papillary carcinoma were similarly evident in both LBC preparations.
SurePath seems to be superior to ThinPrep for diagnosing benign entities based on adequate representation of colloid and lymphocytes. The cell quality of both techniques in thyroid FNA was comparable, while each method introduces its own unique cytologic artifacts related to its methodology. We should recognize the cytomorphologic alterations to avoid misinterpretations.
两种广泛应用的液基细胞学（LBC）系统，即 ThinPrep 和 SurePath，采用不同的原理。本研究旨在比较两种技术制备的甲状腺病变的细胞形态学。
我们回顾性分析了 44 例 LBC 甲状腺细针穿刺标本，包括 20 例 ThinPrep 和 22 例 SurePath。根据 Bethesda 系统进行细胞学诊断，并评估细胞形态学参数。
无细胞涂片在 ThinPrep 中明显比 SurePath 更常见（10%比 0%）。两种技术均产生清洁的背景，良好的细胞保存，且无明显的细胞皱缩。ThinPrep 的细胞数量明显低于 SurePath（25%比 4.3%）。ThinPrep 产生了大量的细胞扁平化和碎片化簇，而 SurePath 包含了三维结构中的较大簇。ThinPrep 中的胶体明显减少且碎片化，而在 SurePath 中容易观察到。在桥本甲状腺炎病例中，ThinPrep 在背景中产生的白细胞明显少于 SurePath。在 16 例（62.5%）经 ThinPrep 处理的病例中，经常出现纤维蛋白和白细胞的聚集物。在 6 例（37.5%）经 ThinPrep 处理的病例中，在环的外周存在空气干燥伪影。两种 LBC 制备物中乳头状癌的核特征均相似。
基于胶体和淋巴细胞的充分表现，SurePath 似乎优于 ThinPrep 用于诊断良性实体。两种技术在甲状腺细针穿刺中的细胞质量相当，但每种方法都引入了与其方法学相关的独特细胞学伪影。我们应该认识到这些细胞形态学改变，以避免误诊。
