Stromal edge involvement in FNB of pancreatic ductal adenocarcinoma: An important diagnostic clue

IF 2.9 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2026-10-05 DOI:10.1002/cncy.70157

Dina Zenezan MD, M. Lisa Zhang MD, Martha Pitman MD

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引用次数: 0

Abstract

Background

SharkCore fine-needle biopsy (FNB) provides ample intact tissue for rapid on-site evaluation and ancillary studies. Diagnosing well-differentiated pancreatic ductal adenocarcinoma (PDAC) remains challenging, particularly in the absence of stromal invasion. The diagnostic significance of edge involvement (EI), defined as ductal epithelial cells at the edge of stromal fragments, in SharkCore FNB specimens of PDAC, was evaluated.

Design

A total of 42 PDAC FNBs were reviewed over a 1-year period. Smears and corresponding histology specimens were evaluated for the presence of EI, stromal invasion, and detached background tumor cells. Histology specimens were classified as low-grade (well/moderately differentiated) or high-grade (poorly differentiated). A benign cohort of 27 pancreatic FNBs was included.

Results

On smears, EI was identified in 39/42 (92.9%), stromal invasion in 22/42 (52.4%), and detached background tumor cells in 41/42 (97.6%) cases. On histology, EI was present in 38/42 (90.5%), stromal invasion in 32/42 (76.2%), and background tumor cells in 37/42 (88.1%) cases. One case showing EI was initially interpreted as benign but was found to be a low-grade PDAC on repeat FNB. On histology, EI without stromal invasion was observed in 7/26 low-grade tumors, whereas stromal invasion with EI was present in 15/16 high-grade tumors. In the benign cohort, EI was absent on histology but identified in 2/27 smears (7.4%), both lacking follow-ups. EI was significantly more frequent in PDAC, with sensitivity/specificity of 92.9%/92.6% in smears and 90.5%/100.0% in histology.

Conclusion

EI is a specific diagnostic clue for PDAC that improves diagnostic confidence, particularly in low-grade tumors.

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胰腺导管腺癌FNB浸润间质边缘：一个重要的诊断线索。

背景：SharkCore细针活检（FNB）为快速现场评估和辅助研究提供了充足的完整组织。诊断高分化胰腺导管腺癌（PDAC）仍然具有挑战性，特别是在没有间质浸润的情况下。评估了PDAC的SharkCore FNB标本中边缘受累（edge involvement， EI）的诊断意义，定义为基质碎片边缘的导管上皮细胞。设计：在1年的时间里，共审查了42个PDAC fnb。涂片和相应的组织学标本评估是否存在EI、基质浸润和分离的背景肿瘤细胞。组织学标本分为低级别（高/中分化）和高级别（低分化）。良性队列包括27例胰腺fnb。结果：在涂片上，39/42例（92.9%）发现EI， 22/42例（52.4%）发现间质浸润，41/42例（97.6%）发现背景肿瘤细胞分离。组织学上，EI占38/42(90.5%)，间质浸润占32/42(76.2%)，背景肿瘤细胞占37/42（88.1%）。1例EI最初被解释为良性，但在重复FNB中发现了低级别PDAC。组织学上，7/26的低级别肿瘤中有EI未见间质浸润，而15/16的高级别肿瘤中有EI的间质浸润。在良性队列中，组织学上未见EI，但在2/27的涂片中发现（7.4%），均缺乏随访。EI在PDAC中更为常见，涂片敏感性/特异性为92.9%/92.6%，组织学敏感性/特异性为90.5%/100.0%。结论：EI是PDAC的特异诊断线索，提高了诊断的可信度，尤其是对低级别肿瘤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.