The diagnosis of breast cancer by fine-needle aspiration smears.

Forty-eight percent of 93 breast carcinomas that were aspirated with a fine needle were found to be cytologically positive for carcinoma, and in another 31% this diagnosis was suspected. Care of most breast cancer patients with abnormal or questionable aspiration smears was affected by cytological diagnosis. Thirty-seven patients with a positive diagnosis for carcinoma and with consistent clincal findings were informed of the diagnosis prior to surgery and underwent modified radical mastectomies without further frozen-section examination. Twelve other patients with suspect or abnormal cytological reports had biopsies performed earlier because of these findings. A cytopathological diagnosis of carcinoma based on aspiration smears of the breast is highly accurate if strict criterions of malignancy are applied, but normal smears from solid breast masses do not exclude malignancy.     

甲状腺结节细针穿刺检查782例临床病理分析

目的分析甲状腺结节细针穿刺（FNAB）检查的诊断结果及其应用价值。方法回顾性分析782例行FNAB检查患者的临床病理资料。细胞病理诊断分为6类,为未诊断、良性病变、滤泡性病变、滤泡性肿瘤、可疑恶性和恶性。对其中手术治疗的76例患者的组织病理与细胞病理进行对比,判断细针穿刺的准确性。结果782例行FNAB检查患者中,良性病变占74．4％（582／782）,恶性诊断只占2．6％（20／782）,滤泡性肿瘤占5．6％（44／782）,滤泡性病变、可疑恶性分别为3。2％（25／782）和2．9％（23／782）,未诊断者占11．3％（88／782）。76例手术患者中,组织病理诊断良性疾病占65．8％（50／76）,恶性肿瘤占28．9％（22／76）,良性肿瘤占5．3％（4／76）。在细胞病理诊断为良性和恶性两大类中,与组织病理的符合率较高,分别为16／16和16／17。结论甲状腺细针穿刺是甲状腺结节诊断和鉴别诊断的可靠方法。     

超声引导下乳腺小病灶78例的粗针穿刺活检

目的:分析超声引导下对触摸不清的乳腺病灶进行穿刺活检细胞学和病理学检查的诊断准确率。方法:70例女性中检出78个触摸不清的乳腺结节,在超声引导下用18g穿刺针穿刺活检。以术后病理诊断和随诊结果为标准,分析穿刺细胞学和病理组织学检查的诊断准确性。结果:穿刺细胞学诊断为良性者58个,可疑恶性者6个,有恶性细胞者14个,其中证实为恶性者分别为1个、2个和13个。敏感性为93.8%,特异性为91.9%,诊断准确率为92.3%;穿刺病理学诊断为良性病变者63个,恶性者15个,证实为恶性者分别为1个和15个,敏感性为93.8%,特异性为100%,诊断准确率为98.7%。2种方法的特异性一致,而敏感性和诊断准确率差异有统计学意义(P<0.05)。结论:对于不能触及的乳腺结节,超声引导下乳腺粗针穿刺的细胞学和病理学检查是可靠的诊断方法,且后者更有效。     

甲状腺结节细针穿刺细胞学检查63例分析

目的:评价细针穿刺细胞学检查(FNAC)在甲状腺结节诊断中的作用。方法:对比分析63例甲状腺结节细针穿刺后行手术治疗患者的细胞病理学与组织病理学诊断结果。结果:细针穿刺细胞学结果与术后组织病理学诊断结果比较,诊断总符合率为90.48%(57/63),FNAC判断甲状腺良恶性结节性质的敏感性、特异性和诊断准确率分别为78.95%、95.45%和90.48%。结论:FNAC对甲状腺结节良恶性诊断价值较高,与组织病理学检查总体诊断符合率较好,是一种安全、有效的术前确诊手段。     

超声引导下细针穿刺抽吸活检对TI-RADS 4类甲状腺结节的诊断价值

目的探讨超声引导下细针穿刺抽吸活检（US-FNAB）对甲状腺超声影像报告和数据系统（TI-RADS）4类甲状腺结节的诊断价值。方法回顾性分析在上海交通大学医学院附属瑞金医院接受US-FNAB检查的甲状腺患者的术前超声特征,根据TI-RADS评估每个结节的恶性风险并进行分类,将其中TI-RADS 4a、4b和4c类共265例患者的281个结节纳入为可疑结节,所有结节均行US-FNAB检查,排除细胞学无相关诊断（不满意）结果的病例,将入组的274个结节的US-FNAB细胞学诊断结果与病理结果或随访结果进行对照研究。结果 281个TI-RADS 4类结节中,细胞学诊断恶性97个,可疑恶性45个,良性120个,不满意7个,不确定12个;经术后病理或临床随访,恶性146个,良性128个,US-FNAB细胞学结果和实际结果比较差异有统计学意义（P〈0.001）。US-FNAB细胞学诊断TI-RADS 4类甲状腺结节的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为93.83%、96.09%、96.48%、93.18%和94.89%。结论 US-FNAB检查对TI-RADS 4类甲状腺结节有较高的诊断价值,能有效提高术前诊断的准确性。TI-RADS分类有助于甲状腺可疑结节临床处理方式的选择。     

Cytodiagnosis of pancreatic and biliary cancer by endoscopic duct aspiration.

Duct aspiration was performed immediately after endoscopic retrograde cholangiopancreatography (ERCP) in 33 patients with ductal changes which were suggestive of pancreatic or biliary cancer. Malignant cells were identified in 10 of 17 patients (60%) with cancer of the pancreas, and in two of 10 patients (20%) with cancer of the biliary tract. Atypical cells were identified in additional patients with cancer, but cytological characteristics did not permit a definitive diagnosis. No false positive diagnoses were made. Duct aspiration is a relatively simple extension of ERCP, and enhances diagnostic accuracy, particularly in patients with carcinoma of the pancreas.     

Diagnosis of breast lump by fine needle aspiration cytology and mammography

Breast carcinoma is the most common malignant tumour and the leading cause of death from cancer in women. A large number of patients in Bangladesh have been suffering from breast cancer. Now-a-days, Fine needle aspiration cytology (FNAC) is being performed as a pre-operative test to evaluate breast lump. FNAC is cost effective and can prevent unnecessary surgery. As FNAC became more reliable in diagnosing malignancy and thereby the use of frozen-section histology had been reduced by about 80%. But erroneous diagnosis is more common with FNAC than with histopathology. However, mammography can identify breast cancers too small to palpate on physical examination and theoretically beneficial to diagnose even noninvasive lesions. Present study aimed to see the accuracy of FNAC and mammography in the diagnosis of palpable breast lumps and to study their correlation. In this study 222 patients were included in the study and FNAC was done in all the patients. Mammography was done in 112 cases. Among these 112 patients 32 cases were found malignant. Histopathology was done in total 89 cases. Among 112 patients who were underwent mammography only 43 were found for histopathology. Finally, 36 cases were found malignant. Fibroadenoma is mostly found in below 20 years group and malignancy is mostly occurring in older age group. Mammography shows total 8 false positive and 5 false negative cases. FNAC shows only 1 false positive and 1 false negative case. On analysis mammography showed 82.76% sensitivity, 90.36% specificity, 75% Positive predictive value (PPV), 93.75% Negative predictive value (NPV) and 88.39% accuracy. FNAC showed 97.22% sensitivity, 99.46% specificity, 97.220% PPV, 99.46% NPV and 99.095% accuracy. Mammography was found to be less sensitive, specific and accurate in the diagnosis of breast lump though there is highly significant correlation among them. However, the study has shown a much higher performance of FNAC than other previous studies indicating the improved skill in cytological diagnosis to a satisfactory level.     

针吸细胞学检查在深部肿瘤切除术快速诊断中的应用研究

目的 探讨细针抽吸细胞学检查在深部肿瘤术中快速诊断中的价值。方法 对临床上手术探查或手术治疗的116例深部肿瘤患者采用20－30ml空针,9号注射针头,对手术中暴露的肿瘤组织进行直视下抽吸,抽吸物涂片自然干燥后,进行瑞－姬氏和AgNOR染色,油镜下进行细胞学综合诊断。结果 116例肿瘤患者经术中单纯细胞学形态学诊断为恶性肿瘤65例（56．0％）,良性肿瘤51例（44．0％）。与AgNOR染色结果结合后,其术中细胞学诊断为恶性肿瘤78例（67．2％）,良性肿瘤38例（32．8％）。细胞学诊断良恶性肿瘤的准确性显著高于术中组织学快速诊断结果,与术后病理组织学诊断结果完全相符56例（48．3％）,基本相符60例（51．7％）,未出现假阳性和假阴性诊断结果,总阳性符合率为100％。结论 术中针吸细胞学诊断结果准确率高（达100％）,诊断时间短（0．5h左右）,并且针吸创伤小,其并发症和假阴性均低于活检。针吸细胞学检查是用于深部器官、组织肿瘤诊断和鉴别诊断的重要手段,可为临床及时对深部器官、组织肿瘤的正确治疗提供重要依据。     

细针吸取活检细胞学在乳腺癌诊断中的应用

目的：探讨细针吸取活检细胞学对乳腺癌的诊断价值。方法：以术后病理诊断为对照（１３４例）,光镜下观察５２１例乳腺肿瘤的针吸涂片。结果：在５４例乳腺癌中,细胞学诊断正确者４９例（９０．７％）,可疑者４例（７．４％）,假阴性者１例。同期细胞学诊断为乳腺癌者未见假阳性。结论：细针吸取活检对乳腺癌的定性和分级诊断均准确可靠。     

Intra-operative frozen section diagnosis of breast lesions: a retrospective analysis of 13 243 Chinese patients

Background Although cytological methods for breast oncology have been used in recent decades, intra-operative frozen section has been playing a vital role in making therapeutic decisions. We analyzed a large series of frozen section diagnoses for Chinese cases of breast lesion within the last 15 years. The experience was expected to increase the diagnostic accuracy of cases with breast lesions. Methods The data from consecutive 13243 cases of breast lesions diagnosed with intra-operative frozen sections between 1988 to 2002 were compared with paraffin sections in a case by case manner. The causes of false negative and positive diagnoses as well as delayed diagnoses were analyzed. Results One hundred and seventeen cases （0.9%） were falsely diagnosed, with one false positive case and 116 false negative cases. The diagnosis of 47 cases （0.4%） was delayed. The proportion of several lesions had the features of the patients＇ ages. Six types （false invasion, peri-papUloma, adenoma of nipple duct, florid adenosis, sclerosing adenosis, and granulose cell tumor） of lesions may lead to false positive, and four types （morphological changes responding chemotherapy, well differentiated papillary carcinoma, invasive Iobular carcinoma, and tubular carcinoma） to a false negative. Gross and microscopic findings may be inconsistent in two types of lesions （radial scar and florid adenosis） microscopic and clinical findings in three types （ganulomatous mastitis mammary, duct ectasia, and fat necrosis）, and three types （abundant fat or sclerous tissues; borderline lesions and changes of post-chemotherapy） were likely wrongly classified. Conclusions Intra-operative frozen section can accurately identify breast lesions in many instances, leading to fewer errors on account of more diaanostic experience and understandina of diaanostic limitations.     

甲状腺肿物超声、CT与超声引导下穿刺活检结果对照分析

目的对甲状腺肿物超声、CT及超声引导下穿刺活检(US-FNAB)诊断结果进行对照分析。方法收集2017年1月-2018年12月就诊于医院并经手术病理明确诊断的甲状腺肿物患者96例,术前均行超声、CT及US-FNAB检查,将超声、CT及US-FNAB检查结果与手术病理结果进行对照分析。结果96例患者,手术病理证实甲状腺乳癌33例,结节性甲状腺肿59例,腺瘤4例。以手术病理结果为金标准,超声诊断的敏感度为77.1%,特异度为80.3%,准确度为79.2%;CT诊断的敏感度为68.6%,特异度为75.4%,准确度为72.9%;二者诊断的敏感度、特异度、准确度对比均无统计学差异(P>0.05)。US-FNAB检查诊断的敏感度、特异度、准确度分别为94.3%、100.0%、97.9%,均明显高于超声及CT检查(P<0.05)。结论超声或CT均有助于甲状腺肿物的早期筛查,但其诊断准确度较低;而US-FNAB检查诊断的准确度较高,可在术前明确病理诊断。     

235例乳腺肿块针吸细胞学检查结果分析

本文总结有病理组织学证实的乳腺肿物针吸细胞学检查235例,结果表明本组乳癌细胞学诊断阳性率为80%,假阴性14．5%,无假阳性报告。结合涂片观察,本文提出了乳腺肿块针吸细胞学的良恶性鉴别标准,讨论了导致假阳性和假阴性的原因。     

乳腺定位穿刺与手术切除标本病理对比观察

目的 探讨乳腺X线定位穿刺活检及活检标本免疫组化的诊断价值。方法 对130例乳腺定位穿刺活检与手术切除活检进行病理形态对比观察，并对其中39例乳腺癌穿刺标本及手术标本均作免疫组化ER、PR、C-erbB-2标记检测。结果 130例乳腺定位穿刺活检与手术活检结果符合126例，符合率96．9％；乳腺癌穿刺标本免疫组化ER、PR、C-erbB-2检测结果与手术切除标本基本相符，符合率分别为95．9％、94．9％和94．4％。结论 乳腺X线定位穿刺活检准确，技术创伤小，具有重要的临床价值；穿刺标本代替手术切除标本检测一些免疫组化指标完全可行。     

1500例乳腺肿块细针吸取细胞学检查的临床应用

目的探讨细针吸取细胞学检查在乳腺肿块中的应用价值。方法复习乳腺肿物细针吸取细胞学检查1500例。与其中手术后获病理组织学诊断的415例做对照比较。结果1500例全部为女性，年龄11-88岁，平均38．6岁。415例手术病例中组织学为良性病变的197例中，细胞学诊断有1例不符，诊断为癌。组织学诊断为恶性肿瘤的218例，细胞学诊断有6例不符，诊断为良性。本组的敏感性、特异性、总准确度、假阴性和假阳性分别为97．25％，99．49％，98．31％，2．75％，和0．51％。结论细针吸取细胞学对乳腺肿物诊断具安全、可靠等优点，可作为乳腺肿物常规检查手段，值得推广应用。     

The role of needle aspiration cytology in the differential diagnosis of accessible paediatric tumours

In the period 1985-88, 171 fine needle aspirates from paediatric patients with malignant and non-neoplastic masses were processed and evaluated in the Department of Haematology, Kenyatta National Hospital, Nairobi. Sixty-five needle aspirates had the diagnosis corroborated by histological reports. The rest had relevant clinical and laboratory information to support the cytological diagnosis. The histological diagnosis confirmed cytological diagnosis in 100% for neuroblastoma, 96% for Burkitt's lymphoma, 75% for carcinoma, 68% for sarcoma cases, 53% non-Hodgkin's lymphoma and 50% for Hodgkin's lymphoma. There were no false positives. It is therefore concluded that fine needle aspiration is a useful tool. It may obviate diagnostic surgery, help in planning the course of management of patients and it is diagnostic in Burkitt's lymphoma and neuroblastoma. Fine needle aspiration cytology is an easy, cheap and quick investigation compared to surgical biopsy.     

DNA倍体分析系统在乳腺包块针吸细胞学诊断中的应用

目的用全自动倍体分析系统判别乳腺肿瘤恶性程度。方法对51例妇女乳腺包块行穿刺针吸细胞涂片，做瑞氏染色行常规细胞学检查，用Feulgen染色做全自动DNA图像分析。结果常规细胞学和DNA倍体分析系统对19例良性乳腺疾病诊断一致。常规细胞学可对32例乳腺癌作出正确诊断，而DNA倍体分析系统只诊断出27例乳腺癌。乳腺癌早期，细胞核为2倍体（DNA定量为2C），核面积略大；而乳腺癌晚期，可出现5C，甚至9C异倍体细胞，核面积明显增大。结论DNA倍体分析系统对判断乳腺肿瘤恶性程度有一定意义。     

CT导引下肺内病变经皮穿刺活检--大、小病灶的比较

目的 :探讨CT导引下穿刺活检对肺内小病灶的诊断价值及病灶大小对诊断正确率和并发症发生率的影响。方法 :回顾复习有手术病理、临床或影像学随访的肺内病变CT导引下活检 2 74例 ,其中小病灶 (Φ≤ 2cm) 5 2例 ,大病灶 (Φ >2cm) 2 2 2例。依据手术病理或临床随访结果判断活检病理诊断结果是否正确。比较大、小病灶在诊断正确率和并发症发生率方面的差异。结果 :CT导引下穿刺活检对肺内小病灶诊断正确率73 .1 % (3 8/5 2 )显著低于对大病灶的诊断正确率 89.2 % (1 98/2 2 2 ) (P <0 .0 1 )。小病灶气胸发生率 (1 5 .4% )略高于大病灶 (1 2 .6% ) ,两者间无统计学差异 (P >0 .0 5 )。结论 :CT导引下经皮经胸穿刺活检对肺内小病灶是一种安全、准确的诊断和鉴别诊断方法。     

Efficacy of a modified ultrafast Papanicolaou (UFP) stain for breast aspirates

Rapid assessment of fine needle aspiration smears has become popular. The goal is minimal time required and fastest turn around time for test results in breast aspirates. In the present study, fine needle aspiration smears from 100 cases of breast lump were stained by modified ultrafast Papanicolaou stain which consisted of the following changes from ultrafast Papanicolaou stain: (i) Use of Gill 's haematoxylin instead of Richard Allan haematoxylin, (ii) omission of orange G from cytostain. Wet fixed smears subjeted to May-Gruenwald and Giemsa stain and an air dried smear subjected to modified ultrafast Papanicolaou stain were compared. Smears stained by modified stain showed transparent cells with crisp nuclear features in a blood free background. Total time required in this staining was 130 seconds. Out of 100, diagnosis was inadequate in 5 cases. In 95 cases cytological diagnosis was as follows: 60 benign, 27 ductal malignancy and 8 of inflammatory lesions. There was 100% agreement in cytologic diagnosis offered on smears stained by May-Gruenwald and Giemsa and modified ultrafast Papanicolaou stain.     

细针穿刺检查对甲状腺结节的诊断进展

甲状腺结节(thyroid nodule,TN)是内分泌系统的常见病和多发病。因其具有良、恶性之分,治疗方案及预后有显著不同。但恶性结节在临床上多缺乏特征性表现,同时常规的检查手段在良、恶性鉴别方面的表现并不理想。细针穿刺检查(fine-needle aspiration,FNA)通过获取甲状腺可疑结节的少量组织进行细胞学诊断,可有效提高良、恶性质鉴别的准确度,为临床提供重要的诊断依据。本文就近年来细针穿刺相关技术及与分子生物学检查的联合在甲状腺结节诊断方面的进展进行综述。     

细针吸取细胞学检查在乳腺癌术前诊断中的价值

目的：探讨细针吸取细胞学（FNAC）检查在乳腺癌术前诊断中的应用价值。方法：回顾性分析520例乳腺癌患者术前细针吸取细胞学诊断结果,并与相应的组织病理学结果对照分析。结果：520例术前FN-CA结果中,诊断IV级者445例,诊断III级者34例,诊断II级者35例,诊断I级者6例。FNCA准确率、假阴性率、假阳性率分别为92.1%7、.9%、0。结论：细针吸取细胞学检查是术前诊断乳腺癌准确、安全、可靠的手段,有较高的应用价值。