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| 1 | 淋巴结转移性鼻咽癌针吸检查中细胞块样本的应用显示文摘目的探讨细针吸取(FNA)涂片联合细胞块(CB)切片、免疫组化标记(IHC)和EBER原位杂交在淋巴结转移性鼻咽癌中的应用。方法采用友谊式细针穿刺器和21G注射针对31例鼻咽癌头颈部淋巴结转移病灶获取样本制片,观察其细胞形态学及CB组织形态学特征、IHC和EBER原位杂交表达。比较分析单纯细胞涂片、细胞涂片联合CB切片、细胞涂片联合CB切片及IHC和EBER原位杂交3种不同方式对鼻咽癌头颈部淋巴结转移病灶的诊断准确率。结果 1所有病例的细胞涂片及CB切片均显示为非角化性癌的形态学特征。2CB切片IHC和EBER原位杂交显示:肿瘤细胞CK5/6、p63、Ki-67及EBER均为(+);LCA和CK7均呈(-)。33种不同方式对鼻咽癌头颈部淋巴结转移病灶的诊断准确率比较显示:单纯细胞涂片诊断的敏感度(90.3%,28/31)及确诊率(74.2%,23/31)最低;细胞涂片联合CB切片诊断的敏感度(93.5%,29/31)及确诊率(77.4%,24/31)居中;细胞涂片联合CB切片及IHC和EBER原位杂交诊断的敏感度(96.8%,30/31)及确诊率(96.8%,30/31)最高。结论FNA细胞涂片联合CB切片、IHC及EBER原位杂交的方式,对头颈部淋巴结转移性鼻咽癌的早期诊断、寻找原发灶、治疗以及预后判断具有重要意义。 | 张燕林 曹敏 余小蒙 杨艳 陈书媛 滕孝静 | 2016 | 诊断病理学杂志2016，23，11： | 8 |
| 2 | Diagnostic yield of EUS-FNA of small(≤15 mm) solid pancreatic lesions using a 25-gauge needle显示文摘Background: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.Methods: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups(≤15 mm, 16–25 mm and >25 mm), and the outcomes were compared.Results: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%,81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size(P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor(P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate(P = 0.018, OR = 1.08).Conclusion: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions. | Stefano Francesco Crinò Maria Cristina Conti Bellocchi Laura Bernardoni Erminia Manfrin Alice Parisi Antonio Amodio Nicolò De Pretis Luca Frulloni Armando Gabbrielli | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 4 |
| 3 | Comparison of cytological and histological preparations in the diagnosis of pancreatic malignancies using endoscopic ultrasoundguided fine needle aspiration显示文摘BACKGROUND:Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) has become a crucial diagnostic technique for pancreatic malignancies.The specimen obtained by EUS-FNA can be prepared for either cytological or histological examinations.This study was to compare diagnostic performance of cytological and histological preparations using EUSFNA in the same lesions when pancreatic malignancies were suspected.METHODS:One hundred and eighteen patients who underwent EUS-FNA for suspected pancreatic malignancies were consecutively enrolled.All procedures were conducted by a single echoendoscopist under the same conditions.Four adequate preparations were obtained by 22-gauge needles with 20 to-and-fro movements for each pass.The 4 preparations included 2 cytological and 2 histological specimens.The pathologic reviews of all specimens were conducted independently by a single experienced cytopathologist.Sensitivity,specificity,and accuracy of the 2 preparations were compared.RESULTS:The enrolled patients consisted of 62 males(52.5%),with the mean age of 64.6±10.5 years.Surgery was performed in 23(19.5%) patients.One hundred and sixteen(98.3%) lesions were classified as malignant,while 2(1.7%) were benign.Sensitivity of cytology and histology were 87.9% and 81.9%,respectively,with no significant difference(P=0.190).Accuracy was also not significantly different.Cytological preparation was more sensitive when the size of lesion was <3 cm(86.7% vs 68.9%,P=0.033).CONCLUSIONS:Our results suggested that the diagnostic performances of cytological and histological preparations are not significantly different for the diagnosis of pancreatic malignancies.However,cytological preparation might be more sensitive for pancreatic lesions <3 cm. | Dong Kee Jang Sang Hyub Lee Jun Kyu Lee Woo Hyun Paik Kwang Hyun Chung Ban Seok Lee Jun Hyuk Son Jae Woo Lee Ji Kon Ryu Yong-Tae Kim Kyoung-Bun Lee | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，4： | 2 |
| 4 | It is necessary to exam bottom and top slide smears of EUS-FNA for pancreatic cancer显示文摘Background: Despite many reports on the diagnostic yield of cytology from endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA), inter-slide differences are unknown. This prospective study aimed to compare diagnostic yield and cellular characteristics of bottom slides(BS) and top slides(TS) from EUSFNA cytology performed without an on-site cytopathologist. Methods: In patients with suspected pancreatic cancer on previous imaging explorations, a single endoscopist performed EUS-FNA and obtained 2 sets of cytology slide(8 BS and 8 TS), 1 cellblock slide, and 1 biopsy slide. Both slide sets were randomly assigned. A cytopathologist with more than 10 years of expertise in pancreatic cytopathology blindly inspected and compared two slide sets. Results: In total, 73 specimens [42 head(57.5%), 16 body(21.9%), and 15 tail(20.5%)] were acquired for final analysis. Seventy-one cases were finally diagnosed with pancreatic cancer. The sensitivity and specificity of BS were 80.3% and 100.0%; and of TS 78.9% and 100.0%, respectively. In analyzing inter-slide difference, 66 cases(90.4%) showed consistent results between BS and TS. However, seven(9.6%) were positive only in one slide sets(4 BS and 3 TS). The proportions of specimens more than moderate and high cellularity were 75.3% and 60.3% in both slide sets( P > 0.99), and the proportion of artifact-free sets were 50.7%, and 52.1% for the BS and TS, respectively( P = 0.869). Conclusions: Although BS and TS exhibited highly consistent diagnostic yields in cytologic smears from EUS-FNA, the proportion of inter-slide discordance is clinically considerable. Both slide sets need to be examined if there is no on-site cytopathologist. | Jong-chanb Lee Haeryoung Kim Hyoung Woo Kim Jongchan Lee Kyu-hyun Paik Jingu Kang Jin-Hyeok Hwang Jaihwan Kim | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，6： | 0 |
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