[Evaluation of the diagnostic significance of cytologic studies in pancreatic tumors].
The study was undertaken to specify cytomorphological criteria for prostatic duct adenocarcinoma (PDAC), by assessing fine-needle aspiration biopsy (FNAB) specimens. Histologically verified cases were selected and the archival cytological material that constituted Leishman stained smears obtained by percutaneous FNAB under ultrasound guidance from 72 patients with PDAC (n = 50) or ductal hyperplasia (DP) (n = 22) was revised. For statistical analysis, the authors selected the following cytological signs of malignancy: anisonucleosis, increased nuclei, hyperchromia, uneven chromatin distribution, enucleation, uneven nuclear outline, apocytes; increased nucleoli, nucleolar polymorphism, multiple nucleoli, increased cells, anisocytosis (polymorphism of the size and shape of a cell, mitoses, piled nuclei, papillary structures, slightly glandular structures. The statistical analysis identified three most important cytological criteria for PDAC: anisocytosis, anisonucleosis, and piled nuclei. Keeping in mind all three signs at once increases the probability of detecting of PDAC up with 90%. The detection of only anisocytosis in the cytological specimen showed a 40% probability of the presence of PDAC. Three additional cytological signs of PDAC were also identified: increased nuclei, uneven nuclear outline, and slightly adhesive structures. The probability of PDAC was 100% if the specimen contained three most significant signs and any of the additional signs. By taking into account the indicators of diagnostic efficiency (DE), the best criteria were as follows: anisonucleosis, uneven nuclear outline, anisocytosis. The optimal indicators of DE for anisonucleosis were 95.83% diagnostic sensitivity (DSen), 95.83% diagnostic specificity (DSp), and 95.83% DE. When two indicators (anisonucleosis and uneven nuclear outline) were simultaneously used, DSen was 93.42; DSp, 98.53% (the highest); DE, 95.83%. Thus, the following cytological signs are defined as important for differentiation of PH and PDAC: anisocytosis, anisonucleosis, piled nuclei, increased nuclei, uneven nuclear outline, slightly adhesive structures.
Pimenova
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Bogatyrev
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VN
Chistiakova
O V
OV
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002648:Child; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology