Sterrett G, Harvey J, Parsons R W, Byrne M J, Jamrozik K, Fitzgerald C J, Dewar J M, Ingram D M, Sheiner H, Cameron F
Department of Histopathology, Sir Charles Gairdner Hospital, Nedlands, Australia.
Aust N Z J Surg. 1994 Nov;64(11):745-9. doi: 10.1111/j.1445-2197.1994.tb04531.x.
A population-based study of all cases of breast cancer diagnosed in Western Australia (WA) in 1989 revealed 701 cases of cancer in 692 women. Three hundred and ninety-six (56.5%) of these cancers had fine needle aspiration (FNA) cytology. Forty-three cases were managed non-surgically, on the basis of an FNA diagnosis and without histologic follow up. Of the cases with histological follow-up, 73% received an unequivocal diagnosis of malignancy by FNA, and abnormal cells (atypical, suspicious or malignant diagnoses) were reported in 94.2%. Of the cases, 3.2% were reported as benign and in 2.6% the samples taken were unsatisfactory. There were no false positive cytological diagnoses of malignancy. This study is the first to examine the results of FNA diagnosis of breast cancer from a medical community as a whole, rather than for individual or specialist units; the accuracy of diagnosis was similar for different pathology practices including public and private sector laboratories. Lower absolute sensitivity (the proportion of cases given an unequivocal diagnosis of malignancy) was seen in very small and very large tumours, pure duct carcinoma in situ (DCIS), and invasive lobular carcinoma. False negative rates (the proportion of cases given a benign cytological diagnosis) were very low for all laboratories (0-4.5%) and for all types of carcinoma, and the proportion of unsatisfactory samples was exceptionally low for all laboratories (0-4.5%). The overall figures for accuracy are similar to those reported from other centres in Australasia and overseas, and confirm the effective use of FNA cytology throughout the clinical and pathology community in WA.
一项基于人群的研究对1989年在西澳大利亚州（WA）诊断出的所有乳腺癌病例进行了调查，结果显示在692名女性中发现了701例癌症。其中396例（56.5%）癌症进行了细针穿刺（FNA）细胞学检查。43例基于FNA诊断且未进行组织学随访而采取了非手术治疗。在进行组织学随访的病例中，73%通过FNA得到了明确的恶性诊断，94.2%报告有异常细胞（非典型、可疑或恶性诊断）。这些病例中，3.2%报告为良性，2.6%所取样本不满意。没有恶性肿瘤的假阳性细胞学诊断。这项研究首次从整个医学界而非个别或专科单位来检查乳腺癌FNA诊断的结果；不同病理实践（包括公共和私营部门实验室）的诊断准确性相似。在非常小和非常大的肿瘤、纯导管原位癌（DCIS）以及浸润性小叶癌中，绝对敏感性（明确诊断为恶性的病例比例）较低。所有实验室（0 - 4.5%）以及所有类型的癌症的假阴性率（给予良性细胞学诊断的病例比例）都非常低，所有实验室不满意样本的比例也极低（0 - 4.5%）。总体准确性数据与澳大利亚和新西兰其他中心以及海外报告的数据相似，并证实了FNA细胞学在西澳大利亚州临床和病理学界的有效应用。
