Cajulis R S, Katz R L, Dekmezian R, el-Naggar A, Ro J Y
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston.
Acta Cytol. 1993 May-Jun;37(3):367-72.
Fine needle aspiration biopsy (FNAB) is increasingly utilized in the initial diagnosis of renal neoplasms. Nuclear grading assessment, however, has not been applied routinely to these neoplasms, and data on its validity are lacking. To determine the reproducibility and clinicopathologic significance of Fuhrman's nuclear grading (FNG) on FNAB specimens, we retrospectively analyzed cytologic and histologic tissues from 49 cases of renal cell carcinomas (RCC). Our data indicate a high concordance between nuclear grading in FNA material and histologic specimens (80-92%). Moreover, interobserver and intraobserver reproducibility was high (89-92% and 86-96%, respectively). The flow cytometric DNA content of 13 specimens (65%) yielded DNA diploidy in five cases (38%) and DNA aneuploid in eight cases (62%). All eight DNA aneuploid neoplasms were FNG 3 (7 cases) and 4 (1 case), while two of the four DNA diploid neoplasms manifested FNG 3. We conclude that cytologic nuclear grading of RCC correlates with corresponding grading of histologic specimens and could be performed reproducibility for clinical use.
细针穿刺活检（FNAB）在肾肿瘤的初始诊断中应用越来越广泛。然而，核分级评估尚未常规应用于这些肿瘤，且缺乏其有效性的数据。为了确定福尔曼核分级（FNG）在FNAB标本上的可重复性及临床病理意义，我们回顾性分析了49例肾细胞癌（RCC）的细胞学和组织学组织。我们的数据表明FNA材料中的核分级与组织学标本之间具有高度一致性（80 - 92%）。此外，观察者间和观察者内的可重复性都很高（分别为89 - 92%和86 - 96%）。13份标本（65%）的流式细胞术DNA含量显示，5例（38%）为DNA二倍体，8例（62%）为DNA非整倍体。所有8例DNA非整倍体肿瘤均为FNG 3级（7例）和4级（1例），而4例DNA二倍体肿瘤中有2例表现为FNG 3级。我们得出结论，RCC的细胞学核分级与组织学标本的相应分级相关，并且可以重复性地用于临床。
