Solé M, Calvet X, Cuberes T, Maderuelo F, Bruix J, Bru C, Rey M J, Serna N, Cardesa A
Department of Pathology, Hospital Clínic i Provincial, University of Barcelona Medical School, Spain.
Acta Cytol. 1993 May-Jun;37(3):309-16.
In order to further evaluate the utility of fine needle aspiration biopsy (FNAB) cytology for the diagnosis of hepatocellular carcinoma (HCC), we analyzed 39 cytologic features in a series of 102 FNABs from HCC and compared them with 28 FNABs from nonneoplastic conditions. Thirteen features were significantly associated with HCC; from them a stepwise logistic regression analysis selected the three most predictive: irregular arrangement, irregular chromatin pattern and uniformly smaller cytoplasm, the last two found only in HCC. Using different specific combinations of significant cytologic features, the highest sensitivity obtained was 84.3%, with 100% specificity. Sixteen HCC cases could not be diagnosed specifically using the criteria defined in this study, probably due to their well-differentiated nature or to sampling error. Although the use of additional techniques, such as cell block preparations, would improve the results in well-differentiated tumors, we recommend basing the early diagnosis of small HCC on a multidisciplinary approach.
为进一步评估细针穿刺活检（FNAB）细胞学检查对肝细胞癌（HCC）诊断的效用，我们分析了102例HCC患者的FNAB样本中的39项细胞学特征，并将其与28例非肿瘤性病变的FNAB样本进行比较。其中13项特征与HCC显著相关；通过逐步逻辑回归分析，选出了最具预测性的三项特征：排列不规则、染色质模式不规则以及细胞质均一性较小，后两项仅在HCC中出现。使用具有显著意义的细胞学特征的不同特定组合，获得的最高敏感度为84.3%，特异性为100%。根据本研究定义的标准，有16例HCC病例无法明确诊断，这可能是由于其高分化性质或取样误差所致。尽管使用额外的技术，如细胞块制备，会改善高分化肿瘤的诊断结果，但我们建议基于多学科方法对小肝癌进行早期诊断。
