Comparison of Thin-Prep and cell block preparation for the evaluation of Thyroid epithelial lesions on fine needle aspiration biopsy
Comparison of Thin-Prep and cell block preparation for the evaluation of Thyroid epithelial lesions on fine needle aspiration biopsy
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DOI：
10.1186/1742-6413-5-3
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发表时间：
2008-01-01
期刊：
影响因子：
1.9
通讯作者：
Khan, Aurang Zeb
中科院分区：
文献类型：
--
作者：
Saleh, Husain A.;Hammoud, Jamal;Khan, Aurang Zeb
背景资料：本研究旨在通过细针穿刺活检（FNAB）比较Thin-Prep（TP）细胞学制备与Cell Block（CB）制备在甲状腺病变（主要是滤泡上皮病变）诊断中的效用。本文还讨论了用TP玻片进行免疫细胞化学染色的可行性。研究方法：由两名细胞病理学家对126例连续甲状腺FNAB与TP载玻片和128例连续甲状腺FNAB与CB载玻片进行盲法审查。记录胶体、滤泡细胞、巨噬细胞和淋巴细胞/浆细胞的存在情况，并根据TP或CB载玻片审查对每例病例进行0-4分评分。细胞学诊断分为以下几类：囊肿、胶样结节、胶样结节囊性变、慢性甲状腺炎、非典型/肿瘤性和非诊断性。结果：TP切片的诊断率高于CB切片。TP切片的诊断率为68，而CB切片的诊断率仅为24。此外，在TP载玻片和相应的直接涂片上仅诊断出4例非典型/肿瘤性病变，而在涂片上诊断出5例非典型/肿瘤性病变，但在相应的CB载玻片上无法诊断。此外，TP载玻片显示了同一病例的直接传统涂片未观察到的细胞学特征。结论：在甲状腺FNAB病例中，TP载玻片制备上级于CB载玻片制备，并且更可能具有用于诊断和检测非典型/肿瘤性甲状腺病变（特别是滤泡细胞起源的病变）的更大细胞构成。此外，TP载玻片似乎可以检测到有用的诊断性细胞学特征，应被视为直接涂片的补充，而不是替代。
Background: The objective of this study was to compare the utility of Thin-Prep (TP) cytologic preparation with that of Cell Block (CB) preparation in the diagnosis of thyroid lesions, mainly follicular epithelial lesions, by fine needle aspiration biopsy (FNAB). Feasibility of using the TP slides for immunocytochemical stains is also discussed. Methods: A total of 126 consecutive cases of thyroid FNAB with TP slides and 128 consecutive cases of thyroid FNAB with CB slides were reviewed blindly by two cytopathologists. The presence of colloid, follicular cells, macrophages and lymphocytes/plasma cells were recorded and scored 0-4 on each case based on TP or CB slide review. The cytologic diagnoses were grouped as follows: cyst, colloid nodule, colloid nodule with cystic change, chronic thyroiditis, atypical/neoplastic and non-diagnostic. Results: The TP slides had higher diagnostic rate than CB slides. The diagnostic yield was 68 of the TP slides whereas only 24 of the CB slides were diagnostic. Also, only 4 atypical/neoplastic lesions were diagnosed on the TP slides and the corresponding direct smears, while 5 cases of atypical/neoplastic lesions were diagnosed on the smears but could not be diagnosed on the corresponding CB slides. Additionally, the TP slides revealed cytologic features that were not observed on the direct traditional smears of the same case. Conclusion: In thyroid FNAB cases, TP slide preparation is superior to CB slide preparation and is more likely to have greater cellularity for diagnosis and detect atypical/neoplastic thyroid lesions, particularly those of follicular cell origin. Furthermore, TP slides appear to detect helpful diagnostic cytologic features and should be considered complementary to, rather than replacing, direct smears.