乳腺病变细针抽吸术的诊断准确性和临床实用性:与手术病理学的相关性。

IF 1.6 4区 医学 Q3 PATHOLOGY
Acta Cytologica Pub Date : 2024-11-27 DOI:10.1159/000542811
Alaa S Hrizat, Kelly A Doxzon, Robert P Post, Elena F Brachtel
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引用次数: 0

摘要

背景:细针穿刺术(FNA)是评估乳腺病变的重要诊断工具,但与核心针活检相比,其使用频率较低。本研究旨在评估 FNA 与手术病理结果相关的诊断性能和临床实用性:我们利用机构数据库进行了为期三年的回顾性检索,以确定介入放射科医生在超声引导下进行乳腺肿块 FNA 的病例。我们审查了细胞病理学报告和玻璃切片,并将细胞学诊断与同时或随后的手术病理学结果进行了关联:结果:共审查了 65 例来自 --- 患者的乳腺 FNA 病例。诊断结果如下23%诊断不充分,11%不典型,8%恶性可疑,3%恶性阳性,55%恶性阴性。FNA 检测恶性肿瘤的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为 76%、96%、93% 和 85%。有一例假阳性病例因退行性病变而被归类为非典型病变,后被证实为良性凋亡。三例假阴性病例最初被归类为非诊断性病例,后来确诊为浸润性导管癌、霍奇金淋巴瘤和乳头状癌。还有一例假阴性病例被归类为恶性肿瘤阴性,后来确诊为浸润性导管癌:结论:乳腺 FNA 虽然比核心针活检少,但却能提供重要的诊断依据,尤其是对囊性病变。该研究表明,FNA 在检测恶性肿瘤方面具有较高的特异性和 PPV,突出了其作为诊断工具与影像学和临床评估相结合的价值。这些研究结果支持在乳腺病变的诊断评估中继续使用 FNA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Accuracy and Clinical Utility of Fine-Needle Aspiration in Breast Lesions: A Correlation with Surgical Pathology.

Introduction: Fine-needle aspiration (FNA) is a valuable diagnostic tool for evaluating breast lesions, yet its use is less frequent compared to core needle biopsies in high-resource settings. This study aimed to assess the diagnostic performance and clinical utility of FNA in correlation with surgical pathology outcomes.

Methods: We performed a 3-year retrospective search (2021-2023) using our institutional database to identify cases of breast mass FNAs performed by interventional radiologists under ultrasound guidance. We retrieved and re-evaluated all glass slides from the archive. Additionally, we reviewed the cytopathology reports and correlated the cytologic diagnoses with concurrent or subsequent surgical pathology results.

Results: A total of 65 breast FNA cases from patients were reviewed. The diagnostic outcomes were 55% negative for malignancy, 23% insufficient for diagnosis, 11% atypical, 8% suspicious for malignancy, and 3% positive for malignancy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value of FNA for detecting malignancy were 76%, 96%, 93%, and 85%, respectively. One false positive case, categorized as atypical due to degenerative changes, was later confirmed as benign apocrine metaplasia. Three false-negative cases, initially categorized as non-diagnostic, were later diagnosed as invasive ductal carcinoma, Hodgkin lymphoma, and papillary carcinoma. An additional false-negative case, categorized under negative for malignancy, was later diagnosed as invasive ductal carcinoma.

Conclusion: Breast FNAs, while less frequently performed than core needle biopsies, provide significant diagnostic insights, particularly for cystic lesions. The study demonstrates high specificity and PPV for FNA in detecting malignancy, underscoring its value as a diagnostic tool when integrated with imaging and clinical assessment. These findings support the continued use of FNA in the diagnostic evaluation of breast lesions.

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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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