Cariaggi M P, Bulgaresi P, Confortini M, Bonardi L, Maddau C, Matucci N, Ciatto S
Centro per lo Studio e la Prevenzione Oncologica, Florence, Italy.
Cytopathology. 1995 Jun;6(3):156-61. doi: 10.1111/j.1365-2303.1995.tb00468.x.
Forty-six (2.9%) false negative reports were recorded among adequate fine needle aspirates from 1609 consecutive histologically proven carcinomas, observed from 1991 to 1993. False negatives were more frequent among younger women (< 40 years = 7.1; 40-49 years = 4.0; 50-59 years = 3.6; 60-69 years = 1.7; > 69 years = 1.5%), lobular invasive subtypes (5.4%), and smaller tumours (pT1a = 4.2; pT1b = 7.6; pT1c = 1.9; pT2 = 2.1; pT3-4 = 1.5%). The latter findings is probably ascribable to better differentiation and less precise sampling of small non-palpable tumours. No significant association was found between the false negative rate and the sampler's or reader's skill and experience. The former finding may be ascribed to the wide use of sonography guided aspiration, even for palpable masses, and the latter to the fact that readers were highly experienced and undergo periodic quality control of individual performance. False negatives were reclassified at reviews as true false negatives, reading errors or inadequates in 27, 11, and eight cases, respectively. The observed findings suggest that in most cases cytological faults were due to the absence of cytological atypia in cells sampled from well differentiated tumours, rather than to misinterpretation or sampling from adjacent normal tissues.
在1991年至1993年间观察到的1609例经组织学证实的连续癌病例中，对足够的细针穿刺抽吸物进行记录，发现46例（2.9%）假阴性报告。年轻女性（<40岁 = 7.1%；40 - 49岁 = 4.0%；50 - 59岁 = 3.6%；60 - 69岁 = 1.7%；>69岁 = 1.5%）、小叶浸润亚型（5.4%）和较小肿瘤（pT1a = 4.2%；pT1b = 7.6%；pT1c = 1.9%；pT2 = 2.1%；pT3 - 4 = 1.5%）中假阴性更为常见。后一发现可能归因于较小的不可触及肿瘤分化较好且取样不够精确。在假阴性率与取样者或阅片者的技能和经验之间未发现显著关联。前一发现可能归因于超声引导下抽吸的广泛应用，即使对于可触及的肿块也是如此，而后一发现归因于阅片者经验丰富且对个人表现进行定期质量控制。在复查时，分别有27例、11例和8例假阴性被重新分类为真正的假阴性、阅片错误或取样不足。观察结果表明，在大多数情况下，细胞学错误是由于从高分化肿瘤中取样的细胞缺乏细胞学异型性，而非由于错误解读或从相邻正常组织取样。
