Agarwal P K, Goel M M, Chandra T, Agarwal S
Department of Pathology and Orthopaedic Surgery, King George's Medical College, Lucknow, India.
Acta Cytol. 1997 May-Jun;41(3):659-65. doi: 10.1159/000332680.
To determine the predictive value of fine needle aspiration cytology (FNAC) of bone lesions.
The study consisted of data retrieval on 200 cases of bone lesions and their cytohistopathologic correlation to assess the diagnostic efficacy of FNAC in these cases, considering histopathology as the gold standard. The diagnostic indices were calculated by a decision matrix comparison.
On cytohistopathologic correlation of 200 cases, 106 (53.0%) were malignant bone tumors (MBT): 97 primary and 9 metastatic; and 76 were benign bone lesions (BBL), 58 neoplastic (29%) and 18 nonneoplastic (9%). The aspirated material was adequate in 181 cases, whereas in 18 cases cytohistopathologic examination revealed no bony lesion. Thus, there were 163 evaluable cases, of which the specific morphologic diagnoses on FNAC were possible in 141 cases (86.5%), with a solitary false positive and 8 false negatives. The percentage of inadequate aspirates was more with BBL (13.2%) than MBT (8.5%). The overall diagnostic accuracy and sensitivity of bone lesions were 95.0%, whereas specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.7%, 99.4% and 69.2%, respectively. The sensitivity of FNAC was better (95.8%) with MBT as compared to BBL (91.7%), whereas specificity and PPV were almost equal (98.8% and 99.2%) in both cases. The NPV in cases of BBL was higher (97.8%) than in MBT (95.2%). These diagnostic indices were calculated excluding the inadequate cases.
High PPV and NPV indicate the reliability of FNAC for the diagnosis of bone lesions.
确定骨病变细针穿刺细胞学检查（FNAC）的预测价值。
本研究包括检索200例骨病变的数据及其细胞组织病理学相关性，以评估FNAC在这些病例中的诊断效能，将组织病理学视为金标准。通过决策矩阵比较计算诊断指标。
对200例病例进行细胞组织病理学相关性分析，106例（53.0%）为恶性骨肿瘤（MBT）：97例原发性和9例转移性；76例为良性骨病变（BBL），58例肿瘤性（29%）和18例非肿瘤性（9%）。181例病例的吸出物足够，而18例病例的细胞组织病理学检查未发现骨病变。因此，有163例可评估病例，其中141例（86.5%）在FNAC上可做出特定的形态学诊断，有1例假阳性和8例假阴性。BBL的吸出物不足百分比（13.2%）高于MBT（8.5%）。骨病变的总体诊断准确性和敏感性为95.0%，而特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为94.7%、99.4%和69.2%。与BBL（91.7%）相比，FNAC对MBT的敏感性更好（95.8%），而两种情况下的特异性和PPV几乎相等（98.8%和99.2%）。BBL病例的NPV（97.8%）高于MBT病例（95.2%）。这些诊断指标是在排除不足病例后计算得出的。
高PPV和NPV表明FNAC对骨病变诊断具有可靠性。
