原位导管癌抽吸物的细胞形态学评估--与组织病理学分级、结构模式和浸润的相关性。

IF 1.6 4区 医学 Q3 PATHOLOGY Acta Cytologica Pub Date : 2024-01-01 Epub Date: 2023-12-21 DOI:10.1159/000535836
Joshua J X Li, Maria B C Y Chow, Joanna K M Ng, Julia Y Tsang, Gary M Tse
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引用次数: 0

摘要

导言:乳腺细针穿刺活检(FNAB)是一种有效且被广泛采用的诊断技术。乳腺导管原位癌(DCIS)的组织病理学分级对预后具有重要意义。在本研究中,对 DCIS 的 FNAB 进行了回顾,以确定可预测分级、组织病理学结构和 DCIS 是否存在侵犯的参数。方法 从组织病理学证实的 DCIS 病例中提取抽吸物,并对细胞形态学参数(包括细胞度、组成、上皮片段结构细胞/核特征)进行复查。结果 共审查了 104 例抽吸样本。细胞病理学细胞特征--核大(p = 0.005)、核仁突出(p = 0.011)、核膜不规则性增加(p = 0.043)、核大小变化大(p = 0.025)、上皮结构中出现凋亡图形(p < 0.001);以及背景碎片(p = 0.033)与高级别诊断相关。细胞质空泡化(p = 0.034)仅见于非高级别抽吸物。上皮碎片结构与分级无关。FNAB 上实性聚集和乳头状碎片占多数(≥ 50%)与组织病理学上的实性(p = 0.039,p = 0.005)和乳头状(p = 0.029,< p = 0.001)形态相关。没有参数显示与浸润相关。结论 FNAB 能有效预测 DCIS 的分级。上皮碎片结构评估仅限于乳头状或实性类型,FNAB 无法预测 DCIS 的病灶侵犯。
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Cytomorphological Assessment in Aspirates of Ductal Carcinoma in situ: Correlations with Histopathologic Grade, Architectural Pattern, and Invasion.

Introduction: Fine-needle aspiration biopsy (FNAB) of the breast is an effective and widely adopted diagnostic technique. Histopathologic grading of ductal carcinoma in situ (DCIS) has prognostic significance. In this current study, FNAB of DCIS was reviewed to identify parameters that predict grading, histopathologic architecture, and presence of invasion in DCIS.

Methods: Aspirates from histopathology-proven cases of DCIS were retrieved and reviewed for cytomorphologic parameters including cellularity, composition, epithelial fragment architecture cellular/nuclear features.

Results: In total 104 aspirates were reviewed. Cytopathologic cellular features - large nuclear size (p = 0.005), prominent nucleoli (p = 0.011), increased nuclear membrane irregularity (p = 0.043), high variation in nuclear size (p = 0.025), and presence of apoptotic figures in epithelial structures (p < 0.001); and background debris (p = 0.033) correlated with a high-grade diagnosis. Cytoplasmic vacuolation (p = 0.034) was seen exclusively in non-high-grade aspirates. Epithelial fragment architecture did not correlate with grading. A predominance (≥50%) of solid aggregates and papillary fragments on FNAB correlated with histopathologically solid (p = 0.039, p = 0.005) and papillary (p = 0.029, < p = 0.001) patterns. No parameter showed correlation with invasion.

Conclusion: FNAB is effective in predicting DCIS grading. Epithelial fragment architecture assessment is limited to papillary or solid types, and FNAB cannot predict focal invasion in DCIS.

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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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