Number of Needle Passes Does Not Correlate with the Diagnostic Yield of Renal Fine Needle Aspiration Cytology
Number of Needle Passes Does Not Correlate with the Diagnostic Yield of Renal Fine Needle Aspiration Cytology
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DOI：
10.1089/end.2008.9724
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发表时间：
2008-10-01
影响因子：
2.7
通讯作者：
Lee, Benjamin R.
中科院分区：
文献类型：
--
作者：
Andonian, Sero;Okeke, Zeph;Lee, Benjamin R.
背景和目的：由于能量消融和主动监测等肾脏病变管理的选择越来越多，肾细针吸取细胞学（FNAC）越来越受欢迎。肾细针穿刺活检的诊断率在40 - 90%之间。我们假设，足够的和诊断FNA样本将与更多的针通过和更高数量的幻灯片investigated.Patients和方法：在我们的机构的病理数据库进行回顾性检索肾FNAC在1995年和2005年之间进行。记录患者性别、侧位、适应症、细胞学诊断、最终组织学诊断（如可用）、进行的进针次数、检查的载玻片数量以及细胞学技师（CS）通过Diff Quik染色确定的FNAC样本的充分性。结果：377例肾活检标本中，259例为内科疾病，118例为FNAC，其中复杂性肾囊肿16例，实性肾肿块102例。不确定的肾囊肿从研究中排除。在102例实性肾脏肿块的FNAC中，22例不充分，13例（59%）为非诊断性; 80例FNAC充分，3例（4%）为非诊断性。非诊断性和诊断性样本之间的穿刺次数无显著差异（2.5 vs 3.2）;样本不足和样本充足之间的穿刺次数无显著差异（3.4 vs 3.0）。同样，非诊断性和诊断性样本（9.5 vs 10.9）之间以及不充分和充分样本（11.3 vs 10.6）之间检查的载玻片数量无显著差异。与Diff Quik不充分样本相比，Diff Quik充分样本的诊断率显著更高（965 vs 41%; p <0.01）。结论：针头通过次数和显微镜检查载玻片的数量与肾脏FNAC的样本充分性或诊断率无关。通过Diff Quik染色确定的样本充分性与诊断性FNAC相关。尽管本研究为回顾性研究，但在FNA过程中，细胞学技术人员应在场，以确保获得足够的样本，以提高肾脏FNAC的诊断率。
Background and Purpose: Renal Fine Needle Aspiration Cytology (FNAC) has gained popularity due to increasing options in management of renal lesions such as energy ablation and active surveillance. The diagnostic yield of renal FNAC varies between 40-90%. We hypothesized that adequate and diagnostic FNA samples would be associated with higher number of needle passes and higher number of slides examined.Patients and Methods: The pathology database at our institution was retrospectively searched for renal FNACs performed between 1995 and 2005. Patient gender, side, indication, cytological diagnosis, final histological diagnosis when available, number of needle passes performed, number of slides examined, and adequacy of the FNAC sample as determined by Diff Quik staining by the cytotechnologist (CS) were recorded. Chi square test was performed for statistical analysis.Results: Out of 377 renal biopsies performed, 259 were core biopsies for medical renal disease, and 118 were FNACs for renal lesions, including 16 for indeterminate complex renal cysts and 102 for solid renal masses. Indeterminate renal cysts were excluded from the study. Out of 102 FNACs for solid renal masses, 22 were inadequate with 13 (59%) being non-diagnostic; and 80 FNACs were adequate with 3 (4%) being non-diagnostic. The number of needle passes was not significantly different between non-diagnostic and diagnostic samples (2.5 vs 3.2); and between inadequate and adequate samples (3.4 vs 3.0). Similarly, the number of slides examined was not significantly different between non-diagnostic and diagnostic samples (9.5 vs 10.9); and between inadequate and adequate samples (11.3 vs 10.6). Diff Quik adequate samples had significantly higher diagnostic yields when compared to Diff Quik inadequate samples (965 vs 41%; p < 0.01).Conclusions: The number of needle passes and microscopic slides examined did not correlate with sample adequacy or diagnostic yield of renal FNAC. Sample adequacy as determined by Diff Quik staining correlated with diagnostic FNAC. Despite the retrospective nature of this study, a cytotechnologist should be present during the FNA procedure to ensure adequate samples have been obtained to increase the diagnostic yield of renal FNAC.