1
|
Lee WY, Wang HC, Tien KJ. Cytomorphological comparison of ThinPrep and SurePath liquid-based cytology in thyroid fine-needle aspiration. Diagn Cytopathol 2024; 52:217-224. [PMID: 38217259 DOI: 10.1002/dc.25274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The two widely established systems for liquid-based cytology (LBC), ThinPrep and SurePath, employ different principles. The aim of this study was to compare the cytomorphology of thyroid lesions prepared by the two techniques. METHODS We retrospectively reviewed 44 thyroid FNA specimens prepared by LBC, including 20 ThinPrep and 22 SurePath. Cytologic diagnoses were made according to the Bethesda system and cytomorphologic parameters were evaluated. RESULTS Acellular smears were significantly frequent in ThinPrep than SurePath (10% vs. 0%). Both techniques produced a clean background, well cell preservation, and not apparent cell shrinkage. ThinPrep showed significantly lower cellularity than SurePath (25% vs. 4.3%). ThinPrep produced considerable flattening and fragmented clusters, while SurePath contained larger clusters in a three-dimensional configuration. Colloid was significantly reduced in amount and fragmented in ThinPrep, and was easily observed in SurePath. In cases of Hashimoto's thyroiditis, ThinPrep produced much less leukocytes in background than SurePath. Aggregates of fibrin and leukocytes were frequently present in 10/16 cases (62.5%) processed by ThinPrep. Air-dry artifact at periphery of the ring was present in 6/16 cases (37.5%) processed by ThinPrep. The nuclear features of papillary carcinoma were similarly evident in both LBC preparations. CONCLUSION SurePath seems to be superior to ThinPrep for diagnosing benign entities based on adequate representation of colloid and lymphocytes. The cell quality of both techniques in thyroid FNA was comparable, while each method introduces its own unique cytologic artifacts related to its methodology. We should recognize the cytomorphologic alterations to avoid misinterpretations.
Collapse
Affiliation(s)
- Wen-Ying Lee
- Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsiu-Chu Wang
- Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan
| | - Kai-Jen Tien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Renxin Clinics, Tainan, Taiwan
| |
Collapse
|
2
|
Erdoğan B, Karabağ A, Kasap HA, Çivi Çetin K, Bal C, Şimşek G. Diagnostic Performance Comparison of Liquid-Based Preparation Methods in Thyroid FNAs. J Cytol 2023; 40:184-191. [PMID: 38058674 PMCID: PMC10697321 DOI: 10.4103/joc.joc_133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 05/19/2023] [Accepted: 09/08/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Fine needle aspiration (FNA) is recognized worldwide as the primary diagnostic method for evaluating thyroid nodules. Samples collected by FNA can be spread directly onto slides, prepared for cell blocks, or processed as liquid-based cytology. Advocates of the traditional smear technique emphasize that background material such as colloid, cell sequencing characteristics in cell clusters, and cellularity is important in cytological diagnosis. They state that these properties are not observed in liquid-based liquids. Liquid-based cytology techniques aim to provide standardized slides of homogeneous cellular smears with well-preserved cell morphology, producing more precise visualization, shorter interpretation time, and more reproducible results. This study aimed to investigate and compare the diagnostic performance of liquid-based thyroid FNA samples prepared with SurePath and Cytospin over the last 6 years. Methods Patients who underwent ultrasound-guided FNA between January 2015 and December 2021 were included in the study. Cytology reports, pathology reports, and demographic information of the patients were collected from the Hospital Information Management System. The programs "SPSS for Windows 21" and "MedCalc Diagnostic Test Evaluation Calculator" were used for data analysis. Chi-square tests were used in crosstab analysis. The Kolmogorov-Smirnov two-sample test, two proportions test, and the confidence interval tests were used to analyze the variables of the methods. P < .05 was considered statistically significant. Results The study population comprised 4,855 patients, 83.8% female and 16.2% male. There were no statistical differences in age and gender distribution in the population of both methods. Nondiagnostic outcome rates were 11.2% for SurePath and 12.8% for Cytospin. Sensitivity, specificity, and accuracy values for SurePath and Cytospin methods were determined as 58.57%, 98.28%, and 91.12% and 79.07%, 96.88%, and 94.03%, respectively. Conclusion In our study, although the qualitative analytical results were slightly in favor of the cytospin method, we think both ways can be used safely, especially in hospitals where the clinics performing sampling activities are variable and many, as well as in pathology laboratories where the workload is intense.
Collapse
Affiliation(s)
- Bahattin Erdoğan
- Department of Patology, T.R Ministry of Health Eskişehir City Hospital, Eskişehir, Turkey
| | - Aral Karabağ
- Department of Radiology, T.R Ministry of Health Eskişehir City Hospital, Eskişehir, Turkey
| | - H. Ahmet Kasap
- Department of General Surgery, T.R Ministry of Health Eskişehir City Hospital, Eskişehir, Turkey
| | - Kısmet Çivi Çetin
- Department of Patology, T.R Ministry of Health Eskişehir City Hospital, Eskişehir, Turkey
| | - Cengiz Bal
- Department of Biostatistics and Medical Informatics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Gülay Şimşek
- Department of Patology, T.R Ministry of Health Yunus Emre State Hospital, Eskişehir, Turkey
| |
Collapse
|
3
|
Qin X, Zhang M, Zhou C, Ran T, Pan Y, Deng Y, Xie X, Zhang Y, Gong T, Zhang B, Zhang L, Wang Y, Li Q, Wang D, Gao L, Zou D. A deep learning model using hyperspectral image for EUS-FNA cytology diagnosis in pancreatic ductal adenocarcinoma. Cancer Med 2023; 12:17005-17017. [PMID: 37455599 PMCID: PMC10501295 DOI: 10.1002/cam4.6335] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/12/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND AIMS Endoscopic ultrasonography-guided fine-needle aspiration/biopsy (EUS-FNA/B) is considered to be a first-line procedure for the pathological diagnosis of pancreatic cancer owing to its high accuracy and low complication rate. The number of new cases of pancreatic ductal adenocarcinoma (PDAC) is increasing, and its accurate pathological diagnosis poses a challenge for cytopathologists. Our aim was to develop a hyperspectral imaging (HSI)-based convolution neural network (CNN) algorithm to aid in the diagnosis of pancreatic EUS-FNA cytology specimens. METHODS HSI images were captured of pancreatic EUS-FNA cytological specimens from benign pancreatic tissues (n = 33) and PDAC (n = 39) prepared using a liquid-based cytology method. A CNN was established to test the diagnostic performance, and Attribution Guided Factorization Visualization (AGF-Visualization) was used to visualize the regions of important classification features identified by the model. RESULTS A total of 1913 HSI images were obtained. Our ResNet18-SimSiam model achieved an accuracy of 0.9204, sensitivity of 0.9310 and specificity of 0.9123 (area under the curve of 0.9625) when trained on HSI images for the differentiation of PDAC cytological specimens from benign pancreatic cells. AGF-Visualization confirmed that the diagnoses were based on the features of tumor cell nuclei. CONCLUSIONS An HSI-based model was developed to diagnose cytological PDAC specimens obtained using EUS-guided sampling. Under the supervision of experienced cytopathologists, we performed multi-staged consecutive in-depth learning of the model. Its superior diagnostic performance could be of value for cytologists when diagnosing PDAC.
Collapse
Affiliation(s)
- Xianzheng Qin
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Minmin Zhang
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Chunhua Zhou
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Taojing Ran
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Yundi Pan
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Yingjiao Deng
- Shanghai Key Laboratory of Multidimensional Information ProcessingEast China Normal UniversityShanghaiChina
| | - Xingran Xie
- Shanghai Key Laboratory of Multidimensional Information ProcessingEast China Normal UniversityShanghaiChina
| | - Yao Zhang
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Tingting Gong
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Benyan Zhang
- Department of PathologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Ling Zhang
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Yan Wang
- Shanghai Key Laboratory of Multidimensional Information ProcessingEast China Normal UniversityShanghaiChina
| | - Qingli Li
- Shanghai Key Laboratory of Multidimensional Information ProcessingEast China Normal UniversityShanghaiChina
| | - Dong Wang
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Lili Gao
- Department of PathologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Duowu Zou
- Department of GastroenterologyRuijin Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| |
Collapse
|
4
|
Lajolo C, Cafiero C, Stigliano E, Grippaudo FR, Chiurazzi P, Grippaudo C. Exfoliative Cytology and Genetic Analysis for a Non-Invasive Approach to the Diagnosis of White Sponge Nevus: Case Series. Bioengineering (Basel) 2023; 10:bioengineering10020154. [PMID: 36829648 PMCID: PMC9952746 DOI: 10.3390/bioengineering10020154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND White Sponge Nevus (WSN) is a rare benign disorder associated with mutations in genes coding for cytokeratin 4 (KRT4) and 13 (KRT13) characterized by dyskeratotic hyperplasia of mucous membranes. This study was aimed at examining different approaches (cytology, pathology and genetic analysis) to WSN diagnosis. METHODS A series of four patients with asymptomatic white diffuse oral lesions were evaluated and, before performing an incisional biopsy for pathology, an oral brush Thin Prep was collected for exfoliative liquid-based cytology (LBC). DNA for genetic analysis was also obtained from patients and both their parents, using buccal swabs. RESULTS Pathology and cytology showed similar results, leading to the same diagnosis of hyperkeratotic epithelium with acanthosis and spongiosis, without atypia, demonstrating the efficiency of LBC for the differential diagnosis. Sequencing analysis revealed at least 6 rare variants in the KRT4 and KRT13 genes in each patient, contributed in part by both unaffected parents. CONCLUSIONS Thin Prep for oral exfoliative cytology and genetic analysis are sufficient for an accurate diagnosis of WSN. The combination of cytological and genetic analyses could substitute the histologic exam, providing a non-invasive alternative for incisional biopsy.
Collapse
Affiliation(s)
- Carlo Lajolo
- Head and Neck Department, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Concetta Cafiero
- Area of Molecular Pathology, Anatomic Pathology Unit, Fabrizio Spaziani Hospital, Via Armando Fabi 2, 03100 Frosinone, Italy
| | - Egidio Stigliano
- Area of Pathology, Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Francesca Romana Grippaudo
- Plastic Surgery Unit, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Pietro Chiurazzi
- Medical Genetics Unit, Institute of Genomic Medicine, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-338-8361006
| | - Cristina Grippaudo
- Head and Neck Department, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| |
Collapse
|
5
|
Mahajan S, Rajwanshi A, Srinivasan R, Radotra BD, Panda N. Should Liquid Based Cytology (LBC) be Applied to Thyroid Fine Needle Aspiration Cytology Samples?: Comparative Analysis of Conventional and LBC Smears. J Cytol 2022; 38:198-202. [PMID: 35002112 PMCID: PMC8670454 DOI: 10.4103/joc.joc_6_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/05/2017] [Accepted: 09/01/2021] [Indexed: 12/23/2022] Open
Abstract
Context: Liquid-based cytology (LBC) is a cyto-preparatory technique that may be applied to fine-needle aspiration (FNA) samples. However, its efficacy over conventional smears (CS) in thyroid is controversial. Aims: The aim of this study was to compare CS versus LBC (SurePath, BD) preparations in thyroid FNA samples for diagnostic efficacy. Settings and Design: Prospective case-control study using split sample analysis in 200 non-consecutive cases of thyroid FNA reported as per the Bethesda system. Methods and Material: Detailed cytomorphological features were evaluated in CS and LBC preparations. Cellularity was scored as 0–3. Based on diagnostic efficacy, they were categorized into three groups:(i) CS and LBC equivalent for diagnosis, (ii) CS better than LBC, and (iii) LBC better than CS for providing the diagnosis. Statistical Analysis Used: Paired t test for cellularity scores and descriptive for diagnostic efficacy. Results: There were 7 unsatisfactory, 118 benign, 10 atypia or follicular lesion of undetermined significance, 25 follicular neoplasms, 6 suspicious for malignancy, and 34 malignant thyroid FNA cases based on routine conventional smears. Cellularity of conventional smears was significantly higher than paired LBC smears (paired t test, P < 0.005). Comparison of overall diagnostic efficacy showed that LBC and CS were equivalent in 59% of cases; CS was superior to LBC in 37% cases and LBC was better than CS in 4% cases only. LBC smears showed higher unsatisfactory rate as compared to CS (18% vs. 3.5%). In category 2, the two techniques were equivalent in 87% of cases. In categories 4 and 6, CS were superior to LBC. Conclusions: In thyroid FNA cases, conventional smears are superior to LBC preparation in terms of cellularity and diagnostic efficacy and hence, LBC preparations should not replace conventional smears for making a routine cytomorphological diagnosis.
Collapse
Affiliation(s)
- Swati Mahajan
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Dass Radotra
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Panda
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
6
|
Evaluation of Thyroid Fine-Needle Aspiration Biopsies according to Cytological Methods and Comparison with Histopathological Diagnosis. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:93-100. [PMID: 33935542 PMCID: PMC8085446 DOI: 10.14744/semb.2020.94752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
Objectives: In this study, we aim to compare the results of aspiration of thyroid nodules evaluated according to the Bethesda category (BC) with tissue diagnoses in the operation materials and to compare the sensitivity, specificity and accuracy rates according to cytology methods. Methods: The previous fine-needle aspiration biopsy (FNAB) of thyroid nodules of 879 cases diagnosed histopathologically between 2010 and 2017 was examined. The FNAB results determined according to the Bethesda system were matched with tissue diagnoses, sensitivity, specificity, and accuracy rates were investigated according to cytology methods. Results: Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and accuracy rates were found in all FNAB results (in units of %; Sensitivity; 84.7, Specificity; 81.1, PPV; 74.1, NPV; 89.2, Accuracy; 82.5). All of the cytological evaluation methods of thyroid FNABs were found to be reliable and effective (Generally, the results are 80% and above). Specificity and accuracy rates were close to the general average (82.5%) in all methods. However, in cases evaluated with liquid base cytology (LBC) method and in addition to LBC or conventional smear (CS), the sensitivity rates in cases where cell block (CB) were evaluated together were higher than cases in which LBC and CS were used alone (92.6% and 91.0%). When examined statistically, there was no significant difference concerning sensitivity, specificity and accuracy rates of cytological methods (p>0.05, respectively, p=0.576, 0.065, 0.643). Conclusion: In cytopathology, when evaluating thyroid aspirations, it is seen that the LBC method is used instead of CS. In our study, we recommend the use of the LBC method, which seems to have the highest sensitivity (taking into account its technical advantages), instead of CS. However, we think that both CS and LBC methods should be evaluated by supporting them with cell block sections.
Collapse
|
7
|
Lobo C, Costa J, Petronilho S, Monteiro P, Leça L, Schmitt F. Cytohistological correlation in serous effusions using the newly proposed International System for Reporting Serous Fluid Cytopathology: Experience of an oncological center. Diagn Cytopathol 2020; 49:596-605. [PMID: 32339444 DOI: 10.1002/dc.24440] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/14/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cytological analysis is part of the initial etiological evaluation of serous effusions. The newly proposed International System for Reporting Serous Fluid Cytopathology (ISRSFC) aims to standardize reporting. METHODS All pleural and peritoneal effusion samples admitted for cytological analysis at our institution between 2012 and 2016, and pericardial effusion samples admitted between 2008 and 2018, were reviewed and reclassified according to the ISRSFC. Risk of malignancy (ROM) and performance parameters were calculated. RESULTS 1496 pleural effusion samples were reclassified: 12(0.8%) non-diagnostic (ND), 944(63.1%) negative for malignancy (NFM), 9(0.6%) atypia of undetermined significance (AUS), 54(3.6%) suspicious of malignancy (SFM) and 477(31.9%) malignant (M). 64 pericardial effusion samples were reclassified: 23(35.9%) NFM, 1(1.6%) AUS, 4(6.3%) SFM and 36(56.2%) M. 763 peritoneal effusion samples were reclassified: 5(0.7%) ND, 457(59.9%) NFM, 12(1.6%) AUS, 37(4.8%) SFM and 252(33%) M. The ROM was, respectively, for each of the aforementioned categories, 57.1%, 23.9%, 50%, 76.2%, 100% in pleural effusions, 100%, 26.3%, 62.5%, 91.7%, 100% in peritoneal effusions and 0% for NFM, 0% for AUS and 100% for M in pericardial effusions. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were, respectively, 61.6%, 100%, 100%, 73.3%, 81.3% for pleural, 100%, 100%, 100%, 100%, 100% for pericardial and 61.2%, 100%, 100%, 70%, 79.7% for peritoneal effusion samples. CONCLUSION Serous effusion cytology has a high specificity and positive predictive value and a modest sensitivity and negative predictive value, supporting its role in confirming the diagnosis of malignancy. The ISRSFC will increase standardization and reproducibility in reporting, leading to improved clinical decision-making.
Collapse
Affiliation(s)
- Cláudia Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - João Costa
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Sara Petronilho
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Paula Monteiro
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Luís Leça
- Department of Pathology, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Fernando Schmitt
- Institute of Molecular Pathology and Immunology of Porto University, Porto, Portugal.,Department of Pathology, Medical Faculty of Porto University, Porto, Portugal
| |
Collapse
|
8
|
Chun JW, Lee K, Lee SH, Kim H, You MS, Hwang YJ, Paik WH, Ryu JK, Kim YT. Comparison of liquid-based cytology with conventional smear cytology for EUS-guided FNA of solid pancreatic masses: a prospective randomized noninferiority study. Gastrointest Endosc 2020; 91:837-846.e1. [PMID: 31759036 DOI: 10.1016/j.gie.2019.11.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/03/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS There are limited data on the efficacy of liquid-based cytology (LBC) for EUS-guided FNA specimens. We aimed to evaluate the diagnostic efficacy of LBC for solid pancreatic neoplasms compared with conventional smears (CSs). METHODS In this randomized, crossover, noninferiority trial, we randomly assigned (1:1) patients with suspected pancreatic cancer to the LBC group or the CS group. Aspirates from the first needle pass were processed by one method, aspirates from the second pass by the other method, and specimens from the last pass were processed as core biopsy samples. The primary endpoint was the diagnostic efficacy of each method, with the final diagnosis as the gold standard. A noninferiority margin of -10% was assumed. RESULTS Of 170 randomized patients, 165 were classified as malignant and 5 as benign. Unsatisfactory samples were less frequent in the LBC group (1.78%) compared with the CS group (5.33%). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of LBC versus CS were 88.0% versus 83.8% (P = .276), 87.7% versus 83.2% (P = .256), 100% versus 100% (P = .999), 100% versus 100% (P = .999), and 16.7% versus 16.1% (P = .953), respectively. A bloody background was significantly more frequent in the CS group (CS, 85.2%; LBC, 1.8%; P < .001), whereas the nuclear features were similar for both groups. CONCLUSIONS The diagnostic usefulness of LBC was comparable with that of CS. The cytomorphologic features did not differ significantly between the 2 methods, and the reduced bloody backgrounds allowed better visibility in the LBC method. (Clinical trial registration number: NCT03606148.).
Collapse
Affiliation(s)
- Jung Won Chun
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyub Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min Su You
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Jung Hwang
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Paik
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Kon Ryu
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Tae Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Farahani SJ, Baloch Z. Are we ready to develop a tiered scheme for the effusion cytology? A comprehensive review and analysis of the literature. Diagn Cytopathol 2019; 47:1145-1159. [PMID: 31301215 DOI: 10.1002/dc.24278] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cytology is widely utilized in the initial evaluation of fluid accumulation in the body cavities. The aim of this study was to determine the accuracy of cytology in distinguishing between benign and malignant (MAL) effusions. METHODS A comprehensive and systematic review of the literature was conducted to evaluate the accuracy of serous effusion cytology (SEC) against tissue biopsy/resection histology, imaging, or clinical follow-up as the reference test. Risk of publication bias and level of heterogeneity in the included studies was assessed. Meta-regression was performed to assess the effect of various variables on the accuracy of SEC. RESULTS Eighty studies met the inclusion criteria for meta-analysis comprising of 34 941 samples; of which 52 (0.2%), 22 202 (72.7%), 194 (0.6%), 711 (2.3%), and 6507 (21.3%) could be reclassified as nondiagnostic (ND), negative for malignancy (NFM), atypical (atypia of uncertain significance-AUS), suspicious for malignancy (SFM), and malignant (MAL), respectively. On follow-up, the mean risk of malignancy for ND, NFM, AUS, SFM, MAL was 17.4%, 20.7%, 65.9%, 81.8%, and 98.9%, respectively. A total of 73 studies were included in estimating the diagnostic accuracy of SEC. The bivariate mixed-effect model estimated the SEC sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio as 73.1%, 99.9%, 7850.6%, 2112.2%, and 0.27%, respectively. CONCLUSION Serous effusion cytology shows high specificity and moderate sensitivity in the evaluation of serous effusions. A tiered classification scheme can improve the consistency of terminology for reporting SEC results, thus improving communication between the pathologists and clinical team, and quality of patient care.
Collapse
Affiliation(s)
- Sahar J Farahani
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Zubair Baloch
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Medical Center, Perelman School of Medicine, Philadelphia, Pennsylvania
| |
Collapse
|
10
|
The management of haemoglobin interference for the MALDI-MSI proteomics analysis of thyroid fine needle aspiration biopsies. Anal Bioanal Chem 2019; 411:5007-5012. [PMID: 31147760 DOI: 10.1007/s00216-019-01908-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/19/2019] [Accepted: 05/09/2019] [Indexed: 12/14/2022]
Abstract
MALDI-MSI represents an ideal tool to explore the spatial distribution of proteins directly in situ, integrating molecular and cytomorphological information, enabling the discovery of potential diagnostic markers in thyroid cytopathology. However, red cells present in the fine needle aspiration biopsy (FNAB) specimens caused ion suppression of other proteins during the MALDI-MSI analysis due to large amount of haemoglobin. Aim of this study was to set up a sample preparation workflow able to manage this haemoglobin interference. Three protocols were compared using ex vivo cytological samples collected from fresh thyroid nodules of 9 patients who underwent thyroidectomy: (A) conventional air-dried smears, (B) cytological smears immediately fixed in ethanol, and (C) ThinPrep liquid-based preparation. Protocols C and A were also evaluated using real FNABs. Results show that protocol C markedly decreased the amount of haemoglobin, with respect to protocols A and B. Protein profiles obtained with protocols A and B were characterised by high inter-patient variability, probably related to the abundance of the haemoglobin, whereas similar spectra were observed for protocol C, where haemoglobin contents were lower. Our findings suggest protocol C as the sample preparation method for MALDI-MSI analysis. Graphical abstract.
Collapse
|
11
|
Piga I, Capitoli G, Tettamanti S, Denti V, Smith A, Chinello C, Stella M, Leni D, Garancini M, Galimberti S, Magni F, Pagni F. Feasibility Study for the MALDI-MSI Analysis of Thyroid Fine Needle Aspiration Biopsies: Evaluating the Morphological and Proteomic Stability Over Time. Proteomics Clin Appl 2018; 13:e1700170. [PMID: 30411853 DOI: 10.1002/prca.201700170] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/18/2018] [Indexed: 11/05/2022]
Abstract
PURPOSE MALDI-MS imaging (MALDI-MSI) is an emerging technology that enables the spatial distribution of biomolecules within tissue to be combined with the traditional morphological information familiar to clinicians. Thus, for diagnostic or prognostic purposes, along with predicting response to therapeutic treatment, it is important to properly collect and handle biological specimens in order to avoid degradation or the formation of artifacts in the morphological structure and proteomic profile. EXPERIMENTAL DESIGN In this work, the morphological and proteomic stability of thyroid fine needle aspiration biopsies in PreservCyt (up to 14 days) and CytoLyt (up to 7 days) solutions at 4 °C has been verified, by MALDI-MSI analysis. Moreover, a new measure has been introduced in order to assess the similarity of the obtained MALDI-MSI spectra, by equally taking into account the number of signals (fit and retrofit), and their intensities (Spearman's correlation and spectra overlap). RESULTS Results show no degradation of the cellular morphology and a good stability of the samples up to 14 days in PreservCyt solution. CONCLUSIONS AND CLINICAL RELEVANCE Moreover, this protocol can be easily implemented in pathological units, allowing simple sample collection and shipment to be used not only for the proteomic MALDI-MSI analysis of thyroid FNABs but also for other biological liquid based specimens.
Collapse
Affiliation(s)
- Isabella Piga
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy.,Department of Medicine and Surgery, Section of Pathology, University of Milano-Bicocca, Monza, Italy
| | - Giulia Capitoli
- Department of Medicine and Surgery, Centre of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza, Italy
| | - Silvia Tettamanti
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Vanna Denti
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Andrew Smith
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Clizia Chinello
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Martina Stella
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Davide Leni
- Department of Radiology, San Gerardo Hospital, Monza, Italy
| | | | - Stefania Galimberti
- Department of Medicine and Surgery, Centre of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza, Italy
| | - Fulvio Magni
- Department of Medicine and Surgery, Clinical Proteomics and Metabolomics Unit, University of Milano-Bicocca, Vedano al Lambro, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, Section of Pathology, University of Milano-Bicocca, Monza, Italy
| |
Collapse
|
12
|
Pastorello RG, Destefani C, Pinto PH, Credidio CH, Reis RX, Rodrigues TDA, Toledo MCD, De Brot L, Costa FDA, Nascimento AG, Pinto CAL, Saieg MA. The impact of rapid on‐site evaluation on thyroid fine‐needle aspiration biopsy: A 2‐year cancer center institutional experience. Cancer Cytopathol 2018; 126:846-852. [DOI: 10.1002/cncy.22051] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/17/2022]
Affiliation(s)
| | - Camila Destefani
- Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil
| | - Pedro H. Pinto
- Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil
- Department of Pathology Base Hospital Federal District Brazil
| | | | - Rafael X. Reis
- Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil
| | | | | | - Louise De Brot
- Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil
| | | | | | | | - Mauro A. Saieg
- Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil
- Department of Pathology Santa Casa Medical School Sao Paulo Brazil
| |
Collapse
|
13
|
Saieg MA, Barbosa B, Nishi J, Ferrari A, Costa F. The impact of repeat FNA in non-diagnostic and indeterminate thyroid nodules: A 5-year single-centre experience. Cytopathology 2017; 29:196-200. [PMID: 29205587 DOI: 10.1111/cyt.12508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 01/21/2023]
Abstract
INTRODUCTION FNA is a well-established method for the preoperative diagnosis of thyroid nodules, but limitations still reside among non-diagnostic and indeterminate samples. The objective of the present study was to assess the impact of repeat FNA in thyroid nodules primarily classified as non-diagnostic and indeterminate, with the evaluation of the diagnostic resolution rate after the reassessment of the nodule. METHODS We retrospectively collected all cases of thyroid FNA at our institution in the last 5 years that had one or more repeat aspirations of the same nodule, calculating the percentage of samples with change in the diagnostic category. Additional collected data included sex, age and interval between the repeat aspirations. RESULTS One hundred and seventy-eight specimens from 167 patients (140 female, 27 male) with a median age of 56 years (range 11-90) were included in the study. Among the 86 cases primarily classified as non-diagnostic, 25 (29.1%) remained in the same category after the first reassessment and only 18 (20.9%) after the second repeat aspiration. Among the 40 indeterminate cases, only 10 (25%) retained their status after the second aspiration, with no change after the third assessment. CONCLUSION Repeat aspiration of non-diagnostic and indeterminate thyroid nodules had a positive impact in both groups, with diagnostic resolution rates of 80% and 75%, respectively. The present study therefore endorses the use of such strategy for the initial follow-up of nodules with no definite diagnosis, especially in low-resource centres with limited access to modern molecular technologies.
Collapse
Affiliation(s)
- M A Saieg
- Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil.,Department of Pathology, AC Camargo Cancer Center, Sao Paulo, Brazil.,Municipal University of São Caetano, São Caetano do Sul, Brazil
| | - B Barbosa
- Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil
| | - J Nishi
- Municipal University of São Caetano, São Caetano do Sul, Brazil
| | - A Ferrari
- Municipal University of São Caetano, São Caetano do Sul, Brazil
| | - F Costa
- Municipal University of São Caetano, São Caetano do Sul, Brazil
| |
Collapse
|
14
|
Rossi ED, Mehrotra S, Kilic AI, Toslak IE, Lim-Dunham J, Martini M, Fadda G, Lombardi CP, Larocca LM, Barkan GA. Noninvasive follicular thyroid neoplasm with papillary-like nuclear features in the pediatric age group. Cancer Cytopathol 2017; 126:27-35. [PMID: 29024469 DOI: 10.1002/cncy.21933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/28/2017] [Accepted: 09/11/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The most common malignant thyroid neoplasm in children is papillary thyroid carcinoma (PTC). In 2015, the Endocrine Pathology Society introduced the terminology "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) to replace the noninvasive follicular variant of PTC. The objective of the current study was to evaluate previously diagnosed PTC in the pediatric population, reappraise it for NIFTP, and discuss the impact of NIFTP on the risk of malignancy (ROM) for each The Bethesda System for Reporting Thyroid Cytopathology category in the pediatric population. METHODS The electronic databases of both study institutions were searched for all thyroidectomy specimens in patients aged <19 years from June 1, 2001 through June 1, 2016. The patient's age, sex, diagnosis, previous fine-needle aspiration cytology diagnosis, and follow-up were tabulated. Slides for available cases were reviewed and cases qualifying as NIFTP were separated. RESULTS The cohort included 101 resected nodules; cytological diagnoses were available for 95 cases. These cases included diagnoses of nondiagnostic (5 cases; 5.2%), benign (21 cases; 22.1%), atypia/follicular lesion of undetermined significance (9 cases; 9.5%), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) (25 cases; 26.3%), suspicious for malignancy (7 cases; 7.4%), and malignant (28 cases; 29.5%). On the histological follow-up, 50 cases (49.5%) were benign, 49 cases (48.5%) were malignant, and 2 cases (1.9%) were NIFTP. These NIFTP cases originally were diagnosed as FNs on fine-needle aspiration cytology. The average ROM for FNs with and without NIFTPs was 28% and 25%, respectively CONCLUSIONS: According to our rate of 1.9% for NIFTPs on reappraisal for resected nodules, this entity is likely to be less frequent in the pediatric population due to the higher prevalence of PTCs and/or more aggressive variants. NIFTPs do not appear to affect the ROM for The Bethesda System for Reporting Thyroid Cytopathology categories in the pediatric population. However, large-scale studies are necessary to determine whether NIFTPs could affect the pediatric population. Cancer Cytopathol 2018;126:27-35. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, "Agostino Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Swati Mehrotra
- Department of Pathology, Loyola University School of Medicine, Maywood, Illinois
| | - Ayse Irem Kilic
- Department of Pathology, Loyola University School of Medicine, Maywood, Illinois
| | - Iclal Erdem Toslak
- Department of Radiology, Loyola University School of Medicine, Maywood, Illinois
| | - Jennifer Lim-Dunham
- Department of Radiology, Loyola University School of Medicine, Maywood, Illinois
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, "Agostino Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Guido Fadda
- Division of Anatomic Pathology and Histology, "Agostino Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.,Division of Endocrine Surgery, "Agostino Gemelli" School of Medicine, University Foundation Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Celestino Pio Lombardi
- Division of Endocrine Surgery, "Agostino Gemelli" School of Medicine, University Foundation Polyclinic, Catholic University of the Sacred Heart, Rome, Italy
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology, "Agostino Gemelli" School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Güliz A Barkan
- Department of Pathology, Loyola University School of Medicine, Maywood, Illinois
| |
Collapse
|
15
|
Rossi ED, Martini M, Cenci T, Capodimonti S, Larocca LM. The role of thyroid FNA cytology in pediatric malignant lesions: An overview of the literature. Cancer Cytopathol 2017; 125:594-603. [DOI: 10.1002/cncy.21884] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/11/2017] [Accepted: 05/11/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology; Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart; Rome Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology; Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart; Rome Italy
| | - Tonia Cenci
- Division of Anatomic Pathology and Histology; Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart; Rome Italy
| | - Sara Capodimonti
- Division of Anatomic Pathology and Histology; Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart; Rome Italy
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology; Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart; Rome Italy
| |
Collapse
|
16
|
Kwon H, Kim WG, Eszlinger M, Paschke R, Song DE, Kim M, Park S, Jeon MJ, Kim TY, Shong YK, Kim WB. Molecular Diagnosis Using Residual Liquid-Based Cytology Materials for Patients with Nondiagnostic or Indeterminate Thyroid Nodules. Endocrinol Metab (Seoul) 2016; 31:586-591. [PMID: 27834083 PMCID: PMC5195836 DOI: 10.3803/enm.2016.31.4.586] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Molecular analysis for common somatic mutations in thyroid cancer can improve diagnostic accuracy of fine-needle aspiration cytology (FNAC) in the nondiagnostic or indeterminate category of thyroid nodules. In this study, we evaluated the feasibility of molecular diagnosis from residual liquid-based cytology (LBC) material after cytological diagnosis. METHODS This prospective study enrolled 53 patients with thyroid nodules diagnosed as nondiagnostic, atypia of undetermined significance (AUS), or follicular lesion of undetermined significance (FLUS) after FNAC. DNAs and RNAs were isolated from residual LBC materials. BRAF(V600E) and RAS point mutations, PAX8/peroxisome proliferator-activated receptor γ (PPARγ), RET/PTC1, and RET/PTC3 rearrangements were evaluated by real-time polymerase chain reaction and pyrosequencing. RESULTS All DNAs from 53 residual LBC samples could be analysed and point mutations were detected in 10 samples (19%). In 17 AUS nodules, seven samples (41%) had point mutations including BRAF (n=4), NRAS (n=2), and KRAS (n=1). In 20 FLUS nodules, three samples (15%) had NRAS point mutations. RNA from only one FLUS nodule could be analysed for rearrangements and there was no abnormality. CONCLUSION Molecular analysis for BRAF and RAS mutations was feasible in residual LBC materials and might be useful for diagnosis of indeterminate thyroid nodules.
Collapse
Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Markus Eszlinger
- Division of Endocrinology and Metabolism, Department of Oncology and Arnie Charbonneau Cancer Institute, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ralf Paschke
- Division of Endocrinology and Metabolism, Department of Oncology and Arnie Charbonneau Cancer Institute, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mijin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suyeon Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
17
|
Chong Y, Baek KH, Kim JY, Kim TJ, Lee EJ, Kang CS. Comparison of EASYPREP(®) and SurePath(®) in thyroid fine-needle aspiration. Diagn Cytopathol 2016; 44:283-90. [PMID: 26848547 DOI: 10.1002/dc.23438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/09/2015] [Accepted: 01/06/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND While fine-needle aspiration cytology (FNAC) using conventional smear has been widely accepted as the primary diagnostic tool for thyroid lesions, liquid-based preparations (LBPs) are increasingly replacing it. A new automated LBP method, EASYPREP(®) (EP), was recently introduced and has shown relevant diagnostic efficacy in gynecologic samples. We compared the diagnostic utility of EP and SurePath(®) (SP), a more widely established LBP method, in thyroid FNAC. METHODS Under the ultrasonographic guidance, 253 thyroid FNAC samples were collected by sample-splitting manner. Three pathologists made cytologic diagnoses of EP and SP according to the Bethesda system independently and compared the cytomorphologic parameters. Cytohistologic correlation was performed in 30 resected cases. RESULTS Fifteen (5.9%) and 21 (8.3%) samples were unsatisfactory in SP and EP, respectively, owing to the unequal sample-splitting. Cytologic diagnoses of SP and EP were consistent in 228 cases (90.1%), and inconsistent in remainder mostly owing to the unequal distribution of pathognomic cells. While cytomorphologic parameters were not significantly different between two methods, EP showed less three-dimensional configuration in benign lesions. Cytohistologic correlation showed no significant differences in sensitivity (100% vs. 95.5%) and specificity (100% vs. 100%) between SP and EP. Labor time for processing 48 cases was 42% shorter with EP than with SP (28 min vs. 48 min). CONCLUSIONS The diagnostic utility of EP in thyroid FNAC was comparable to that of SP. EP allowed better visibility owing to better fragmentation of follicular clusters. The automated system of EP has the advantages of a shorter labor time for batch processing. Diagn. Cytopathol. 2016;44:283-290. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Yosep Chong
- Department of Hospital Pathology, the Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Jee Young Kim
- Department of Radiology, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Jung Kim
- Department of Hospital Pathology, the Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Jung Lee
- Department of Hospital Pathology, the Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Suk Kang
- Department of Hospital Pathology, the Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
18
|
Eleutério J, Aragão A, Cavalcante DIM. Adequacy of Fine-Needle Aspiration Cytology for Breast Lesions: The SurePath® Liquid-Based Technique versus Conventional Smears. Acta Cytol 2015; 59:253-7. [PMID: 26278221 DOI: 10.1159/000437380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/03/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We aimed to assess the cytological findings from fine-needle aspiration (FNA) of breast lesions with conventional smear (CS) and SurePath® (SP) cytology. STUDY DESIGN This was a cross-sectional study of women who underwent FNA from January 2012 to June 2013 for breast lesions with benign ultrasonography impressions in Fortaleza, Brazil. Two groups were formed. The first was composed of 102 samples subjected to CS and the second of 65 samples subjected to SP. The number of smears, the cellularity and the diagnostic hypotheses were compared. Fisher's exact tests with 95% confidence intervals were applied. RESULTS The women ranged in age from 22 to 75 years. SP cytology indicated greater cellularity than CS for the cystic lesions (p < 0.05). In the CS group, 72.5% of the samples required 3-4 slides, but in the SP group, only 9.2% required a second slide. The cellularity of the cystic samples was significantly greater with the SP method (p < 0.01). CONCLUSION In FNA cytology of the breast, SP is a tool that is comparable to CS, but with the added benefits of better cellularity results for cystic lesions and requiring fewer slides for analysis.
Collapse
Affiliation(s)
- José Eleutério
- Faculty of Medicine, Universidade de Fortaleza, Fortaleza, Brazil
| | | | | |
Collapse
|
19
|
Nagarajan N, Schneider EB, Ali SZ, Zeiger MA, Olson MT. How do liquid-based preparations of thyroid fine-needle aspiration compare with conventional smears? An analysis of 5475 specimens. Thyroid 2015; 25:308-13. [PMID: 25420135 DOI: 10.1089/thy.2014.0394] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) plays a pivotal role in the initial evaluation of patients with thyroid nodules. Traditionally, aspirated material is expelled directly onto the microscope slide to make a conventional smear (CS). Recently, liquid-based preparations (LBP) have gained in popularity. This study compares the accuracy of these two preparation techniques in diagnosing thyroid nodules. METHODS A clinical database containing 5475 thyroid cytology consults from 2009 to 2013 was queried to identify 5169 CS and 306 LBP cases. Cytological diagnostic frequency rendered before and after second review were compared between LBP and CS. Correlation with the histology diagnosis was also calculated for each preparatory technique. RESULTS Age, sex, and nodule size were comparable between patients who had FNA processed by LBP and CS. More LBP cases than CS cases were inadequate (17% vs. 10%; p<0.001). LBP cases had fewer benign diagnoses (39% vs. 47%; p=0.003) and tended to have more malignant diagnoses (16% vs. 12%; p=0.09) when compared to CS. Indeterminate and suspicious categories were comparable between LBP and CS. Correlation with histology was also comparable between both techniques. CONCLUSION LBP was associated with a significantly higher proportion of inadequate and a lower proportion of benign diagnoses. Thus, universal adoption of LBP may introduce more inadequate samples. Future investigations should explore the lack of on-site evaluation with LBP as a potential source for the high inadequate rate.
Collapse
Affiliation(s)
- Neeraja Nagarajan
- 1 Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland
| | | | | | | | | |
Collapse
|
20
|
Suzuki A, Hirokawa M, Higuchi M, Yamao N, Kuma S, Nakamura H, Amino N, Miyauchi A. Cytological characteristics of papillary thyroid carcinoma on LBC specimens, compared with conventional specimens. Diagn Cytopathol 2014; 43:108-13. [PMID: 24975688 DOI: 10.1002/dc.23191] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 04/03/2014] [Accepted: 06/11/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND The cytological findings in conventional specimens (C-S) and liquid-based cytology specimens (LBC-S) are not quite same. The aim of this article is to clarify the cytological findings of papillary thyroid carcinoma (PTC) characteristic of LBC-S. METHODS Out of 5,971 cases diagnosed in a single institution from March to September in 2012, 161 PTC cases with both C-S and LBC-S were reviewed. Additionally, we compared the findings with those in LBC-S of 55 adenomatous or hyperplastic nodule (AN) and 21 follicular neoplasm (FN) cases. RESULTS Compared to C-S, the incidences of trabecular and hobnail patterns, collagenous stroma, naked capillaries, intercellular spaces, convoluted nuclei, eosinophilic nucleoli, and perinucleolar halo were increased. Pale nuclei were observed in only one of 161 PTC cases. Specificity of convoluted nuclei and perinucleolar halo were 97.4% and 96.1%, respectively. CONCLUSION Convoluted nuclei and perinucleolar halo might become a new indicator of PTC in LBC-S. Contrarily, we should be aware that pale nuclei are rarely observed in LBC-S.
Collapse
Affiliation(s)
- Ayana Suzuki
- Department of Laboratory, Kuma Hospital, Kobe, Hyogo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Faquin WC. Use of conventional smears versus liquid‐based preparations for fine‐needle aspirate specimens: The time has not come to abandon your conventional smears! Cancer Cytopathol 2014; 122:340-2. [DOI: 10.1002/cncy.21407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 01/29/2014] [Indexed: 11/06/2022]
Affiliation(s)
- William C. Faquin
- Department of Pathology, Massachusetts General HospitalBoston Massachusetts
- Harvard Medical SchoolBoston Massachusetts
| |
Collapse
|
22
|
Lacoste-Collin L, d'Aure D, Bérard E, Rouquette I, Delisle MB, Courtade-Saïdi M. Improvement of the cytological diagnostic accuracy of follicular thyroid lesions by the use of the Ki-67 proliferative index in addition to cytokeratin-19 and HBME-1 immunomarkers: a study of 61 cases of liquid-based FNA cytology with histological control. Cytopathology 2014; 25:160-9. [DOI: 10.1111/cyt.12128] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 01/21/2023]
Affiliation(s)
- L. Lacoste-Collin
- Department of Pathology and Histology-Cytology; Toulouse Rangueil University Hospital; Toulouse Cedex France
| | - D. d'Aure
- Department of Pathology and Histology-Cytology; Toulouse Rangueil University Hospital; Toulouse Cedex France
| | - E. Bérard
- Department of Epidemiology; Health Economics and Public Health; UMR-1027 INSERM Toulouse III University; Toulouse University Hospital; Toulouse France
| | - I. Rouquette
- Department of Pathology and Histology-Cytology; Toulouse Rangueil University Hospital; Toulouse Cedex France
| | - M. B. Delisle
- Department of Pathology and Histology-Cytology; Toulouse Rangueil University Hospital; Toulouse Cedex France
| | - M. Courtade-Saïdi
- Department of Pathology and Histology-Cytology; Toulouse Rangueil University Hospital; Toulouse Cedex France
| |
Collapse
|
23
|
Abedi-Ardekani B, Vielh P. Is liquid-based cytology the magic bullet for performing molecular techniques? Acta Cytol 2014; 58:574-81. [PMID: 25277086 DOI: 10.1159/000366260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 07/31/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The role of pathology has evolved from the first microscopic definitions of diseases by Virchow to the new concept of molecular cytopathology. The management of diseases is now a multidisciplinary approach with the translation of morphological, imagery and molecular findings to therapeutic protocols. Obtaining the most reliable diagnostic material is the essential part of the medical management of patients. STUDY DESIGN Here, we try to gain a concise insight into the available data regarding the role of cytology in the application of molecular techniques, focusing on cancer cytopathology. RESULTS Obtaining cytological material is now feasible by different methods, and in some cases it is the only possible approach to a lesion which is not easily accessible for tissue sampling. The methods of obtaining cytological material have evolved in recent years in parallel with rapid advances in high-throughput molecular techniques, opening new windows for the diagnosis and management of diseases. CONCLUSIONS Different kinds of cytological material are reliable for the application of molecular techniques. Cytological material obtained in a liquid base has advantages such as the better preservation of cytomorphological features and the use of the remaining liquid for nucleic acid extraction even after long storage and the application of molecular methods.
Collapse
Affiliation(s)
- Behnoush Abedi-Ardekani
- Translational Research Laboratory, Personalized Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | | |
Collapse
|
24
|
Ramos MA, Cury FDP, Scapulatempo Neto C, Marques MMC, Silveira HCS. Micronucleus evaluation of exfoliated buccal epithelial cells using liquid-based cytology preparation. Acta Cytol 2014; 58:582-8. [PMID: 25402342 DOI: 10.1159/000366224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/29/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Micronuclei (MN) are biomarkers that can be applied to buccal epithelial cells to assess populations occupationally exposed to potentially carcinogenic agents. Liquid-based cytology (LBC) is a way to improve and refine the results obtained by this test. STUDY DESIGN Exfoliated buccal cells were collected from 40 subjects (20 construction workers from the Barretos Cancer Hospital and 20 administrative staff from the same institution). LBC and three stains (Feulgen/fast green, Papanicolaou and Giemsa) were used to prepare the slides. Student's t test was applied for statistical comparisons of the data. A p value of <0.05 was considered statistically significant. RESULTS Regardless of the stain employed, the frequency of MN was greater in the case group (Feulgen/fast green: 5.15; Papanicolaou: 29; Giemsa: 26) than in the control group (Feulgen/fast green: 2.30; Papanicolaou: 17; Giemsa: 15). CONCLUSIONS Using LBC to prepare slides and evaluate the frequency of MN potentially serves as a screening option for more comprehensive studies of cancer risk among populations occupationally exposed to potentially carcinogenic agents. In addition, the residual fluid enables the preparation of slides for DNA-specific stains that can be compared to those with Papanicolaou stain.
Collapse
|