Ramchandani Lekha, Bajaj Diya, Kumar Rk Vineeth, Bajaj Jitin
Department of Neuropathology, Super Specialty Hospital, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India.
Department of Surgery, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India.
World Neurosurg X. 2024 Feb 25;22:100311. doi: 10.1016/j.wnsx.2024.100311. eCollection 2024 Apr.
Intraoperative squash smear cytology is a useful diagnostic tool in case of CNS lesions. In resource poor countries where frozen section is unavailable, cytology is the mainstay method in giving a rapid intraoperative diagnosis which helps Surgeons regarding the extent of excision. The current study aims to assess the feasibility and accuracy of intraoperative squash cytology in evaluation of CNS tumors. Definitive diagnosis is confirmed by histopathological examination.
This retrospective observational study was carried out at Department of Neuropathology. All patients diagnosed with space occupying lesion (SOL) in CNS were enrolled in the study. Intra-operative cytological diagnosis was compared to histopathological diagnosis. WHO classification of CNS tumors 2021 was used to classify tumors.
Total seventy patients with intracranial SOLs were enrolled in this study who were operated for the same and their specimens were examined. Two samples were found to be inadequate and not included in final analysis. Mean age was 38.8 ± 17.85 (SD). Male-female ratio was 1.5:1 with 41 (60.3%) males and 27 (39.7%) females. 58 had neoplastic and rest 10 had non-neoplastic lesions. Complete concordance was achieved in 61 cases (Diagnostic Accuracy-88.2%). 3 (4.4%) cases showed partial concordance and 4 (5.9%) were discordant. For detection of malignant lesions through squash smear cytology overall Sensitivity was 73.9%, Specificity-97.8%, Positive Predictive Value-94.4% and Negative Predictive Value-88%.
Squash smear cytology is a simple, rapid and cost-effective method relying solely on the expertise of pathologist. High diagnostic accuracy can be achieved with squash cytology by taking clinical and radiological findings into consideration.
术中压片细胞学检查是诊断中枢神经系统（CNS）病变的一种有用的诊断工具。在无法进行冷冻切片检查的资源匮乏国家，细胞学检查是进行快速术中诊断的主要方法，有助于外科医生确定切除范围。本研究旨在评估术中压片细胞学检查在评估中枢神经系统肿瘤方面的可行性和准确性。最终诊断通过组织病理学检查来确认。
本回顾性观察研究在神经病理学系开展。所有被诊断为中枢神经系统占位性病变（SOL）的患者均纳入本研究。将术中细胞学诊断与组织病理学诊断进行比较。采用2021年世界卫生组织中枢神经系统肿瘤分类对肿瘤进行分类。
本研究共纳入70例颅内SOL患者，均接受了手术治疗，并对其标本进行了检查。发现两份样本不合格，未纳入最终分析。平均年龄为38.8±17.85（标准差）。男女比例为1.5:1，男性41例（60.3%），女性27例（39.7%）。58例为肿瘤性病变，其余10例为非肿瘤性病变。61例（诊断准确率-88.2%）实现了完全一致。3例（4.4%）显示部分一致，4例（5.9%）不一致。通过压片细胞学检查检测恶性病变的总体敏感性为73.9%，特异性为97.8%，阳性预测值为94.4%，阴性预测值为88%。
压片细胞学检查是一种简单、快速且经济有效的方法，仅依赖病理学家的专业知识。通过综合考虑临床和影像学检查结果，压片细胞学检查能够实现较高的诊断准确率。
