Bisharah Soudah, Mahmoud Abbas
Institute of Pathology Hannover Medical School (MHH) Hannover Germany.
Gerhard-Domagk Institute of Pathology University Hospital Muenster (UKM) Muenster Germany.
Health Sci Rep. 2025 Jan 12;8(1):e70347. doi: 10.1002/hsr2.70347. eCollection 2025 Jan.
Benign lesions, inflammation, cysts and pseudocysts, as well as neoplasms of the exocrine and endocrine parts of the pancreas can be easily identified using cytological methods. The sensitivity and specificity can be increased with the help of additional examination methods. The sensitivity of intraoperative rapid cytology reaches about 99%. In the literature, the sensitivity reaches an average of about 85% for biopsies. The method is easy to use, has very low complication rates (1%-2%) and is safe for the patient.
1290 cytological samples from pancreatic lesions were processed in the institute of pathology at Hannover Medical School (MHH), as cytological smears and stained with Giemsa and PAS stains as conventional methods. They were compared with the histological specimens that were processed at the same institute. Immunocytochemistry and molecularpathology have been processed only in selected cases. In general, it is routine in the university that the patients give their written consent to participate in clinical studies. The local ethics committee has stated that there is no need for approval due to the retrospective nature of the study.
In this work, we detected 20.077% malignant lesions, 63.333% benign findings and inflammation, 7.441% pseudocysts and cysts. About 9.147% samples were unrepresentative due to insufficient number of cells.
This work will highlight the importance of fine aspiration cytology (FNAC) of suspicious pancreatic lesions, its possibilities and limitations in routine diagnostics with discussing the differential diagnoses, pointing to its great value and safety for patients. FNAC is the gold standard, its power is strongly associated with high specificity and sensitivity in the diagnosis of pancreatic lesions, and is very useful in the differential diagnosis between malignant and inflammatory lesions in pancreas.
使用细胞学方法能够轻松识别胰腺的良性病变、炎症、囊肿和假性囊肿，以及外分泌和内分泌部分的肿瘤。借助其他检查方法可提高敏感性和特异性。术中快速细胞学的敏感性约为99%。在文献中，活检的敏感性平均约为85%。该方法易于使用，并发症发生率极低（1%-2%），对患者安全。
来自胰腺病变的1290份细胞学样本在汉诺威医学院（MHH）病理研究所进行处理，制成细胞学涂片，并用吉姆萨和PAS染色作为常规方法。将它们与在同一研究所处理的组织学标本进行比较。仅在选定病例中进行了免疫细胞化学和分子病理学检查。一般来说，在该大学，患者书面同意参与临床研究是常规操作。当地伦理委员会表示，由于该研究具有回顾性，无需批准。
在这项工作中，我们检测到20.077%的恶性病变、63.333%的良性发现和炎症、7.441%的假性囊肿和囊肿。约9.147%的样本因细胞数量不足而无代表性。
这项工作将突出可疑胰腺病变细针穿刺细胞学检查（FNAC）的重要性，及其在常规诊断中的可能性和局限性，讨论鉴别诊断，指出其对患者的巨大价值和安全性。FNAC是金标准，其效能与胰腺病变诊断中的高特异性和敏感性密切相关，在胰腺恶性与炎症性病变的鉴别诊断中非常有用。
