Nagashima T, Suzuki M, Nakajima N
First Department of Surgery, Chiba University School of Medicine, Japan.
Anal Quant Cytol Histol. 1997 Feb;19(1):49-54.
Papillary thyroid cancer frequently metastasizes to lymph nodes; however, it is generally difficult to make a precise diagnosis preoperatively. The present study was carried out to evaluate lymph node status preoperatively by using quantitative estimations of various cytologic features obtained by fine needle aspiration biopsy from 110 patients with papillary thyroid cancer.
Using a microscope connected to a computerized video system, mean nuclear area (NA) mean circumferential length of nuclei (CL), circular rate (CR), largest to smallest diameter ratio of nuclei (LS), coefficient of variation of NA (NACV), and rates of intranuclear cytoplasmic inclusions (CIs) and nuclear grooves (NG) were calculated and analyzed.
LS, NACV and NG were significantly higher in cases with metastasized lymph nodes than node-negative cases (P < .05, P < .0001, P < .05, respectively). Furthermore, all parameters except CR and LS correlated exactly with the histopathologic features (P < .0001). The number of positive lymph nodes correlated well with the value of NACV, and all cases with recurrences proved to have NACV > 22%.
Preoperative quantitative estimations of cytologic features are useful parameters for the prediction of lymph node metastases in papillary thyroid cancers.
甲状腺乳头状癌常转移至淋巴结；然而，术前通常难以做出精确诊断。本研究旨在通过对110例甲状腺乳头状癌患者细针穿刺活检获得的各种细胞学特征进行定量评估，以术前评估淋巴结状态。
使用连接到计算机视频系统的显微镜，计算并分析平均核面积（NA）、核平均周长（CL）、圆形率（CR）、核最大与最小直径比（LS）、NA变异系数（NACV）以及核内细胞质包涵体（CIs）和核沟（NG）的发生率。
发生淋巴结转移的病例中，LS、NACV和NG显著高于无淋巴结转移的病例（分别为P < 0.05、P < 0.0001、P < 0.05）。此外，除CR和LS外，所有参数均与组织病理学特征完全相关（P < 0.0001）。阳性淋巴结数量与NACV值密切相关，所有复发病例的NACV均> 22%。
术前对细胞学特征进行定量评估是预测甲状腺乳头状癌淋巴结转移的有用参数。
