Pinto M M
Department of Pathology, Bridgeport Hospital, Connecticut, USA.
Acta Cytol. 1996 Mar-Apr;40(2):211-4. doi: 10.1159/000333740.
To compare the sensitivities of cytologic diagnosis by fine needle aspiration (FNA) with carcinoembryonic antigen (CEA) content of cystic brain tumors and to determine if CEA assay enhances the sensitivity of cytologic diagnosis and suggests a probable primary in carcinoma with an unknown primary source.
Thirteen consecutive aspirates were studied. Cytologic diagnosis was confirmed by histologic examination and follow-up. Fluid varied from 3 to 50 mL and from clear to bloody to mucinous. Cytologic examination was performed on Papanicolaou-stained smears. CEA was measured by enzyme immunoassay, with a cutoff of 5 ng/mL.
Benign: 3 (subdural hematoma, 2; arachnoid cyst, 1). Malignant: 10 (medulloblastoma, 1; glioblastoma multiforme, 4; metastatic adenocarcinoma with an unknown primary, 1; of breast, 1; oat cell, 3). Sensitivities: cytology, 50%; CEA, 50%; combined, 60%; specificity, 100%. High CEA (> 880 ng/mL) differentiated papillary adenocarcinoma of lung/gastrointestinal tract from renal and thyroid carcinoma. Mean CEA: oat cell, 216.7 ng/mL; adenocarcinoma, 0.5, > 880 ng/mL; glioblastoma and medulloblastoma, 1.6 ng/mL; benign, 0.6 ng/mL.
High CEA content enhanced the sensitivity of cytologic diagnosis of cystic metastases and favored a primary carcinoma of the lung or gastrointestinal tract.
比较细针穿刺（FNA）细胞学诊断与囊性脑肿瘤癌胚抗原（CEA）含量的敏感性，并确定CEA检测是否能提高细胞学诊断的敏感性，以及是否能提示原发性不明的癌的可能原发部位。
对连续13例穿刺物进行研究。细胞学诊断通过组织学检查和随访得以证实。液体量从3至50毫升不等，性质从清亮到血性再到黏液性。对巴氏染色涂片进行细胞学检查。采用酶免疫测定法检测CEA，临界值为5纳克/毫升。
良性：3例（硬脑膜下血肿2例；蛛网膜囊肿1例）。恶性：10例（髓母细胞瘤1例；多形性胶质母细胞瘤4例；原发性不明的转移性腺癌1例，其中乳腺来源1例；燕麦细胞癌3例）。敏感性：细胞学为50%；CEA为50%；联合检测为60%；特异性为100%。高CEA（>880纳克/毫升）可将肺/胃肠道乳头状腺癌与肾癌和甲状腺癌区分开来。平均CEA水平：燕麦细胞癌为216.7纳克/毫升；腺癌为0.5纳克/毫升，>880纳克/毫升；胶质母细胞瘤和髓母细胞瘤为1.6纳克/毫升；良性为0.6纳克/毫升。
高CEA含量提高了囊性转移瘤细胞学诊断的敏感性，提示可能为肺或胃肠道原发性癌。
