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Correlation of microbiologic culture and fine-needle aspiration cytology: A 14-year experience at a single institution.

微生物培养和细针穿刺细胞学的相关性:单一机构的14年经验

Clement CG,Williams-Bouyer NM,Nawgiri RS,Schnadig VJ

Abstract

Fine-needle aspiration (FNA) is an important tool for the diagnosis of infectious disease. FNA material should be appropriately submitted for cultures when indicated by preliminary findings. Correlation of cytologic diagnoses with culture results are important quality assurance tools. The current study reviewed 14 years of FNA-culture correlation.
FNA cytology-culture correlation records from the years 1996 through 2007 and 2010 through 2011 were retrieved from electronic databases compiled for histology and culture correlation. Correlation was limited to those cases for which material was submitted for culture from the FNA sample. Culture results were retrieved from the laboratory or hospital information system.
Correlative data included 770 cases. Cytology, culture, or both were positive for microbes in 416 of 770 samples (54%), excluding cultured bacterial skin contaminants. Among the 204 bacteria cases, 93 (46%) were identified by cytology and culture, 92 (45%) were identified by culture only, and 19 (9%) were identified by cytology only. Among the 16 cases of Actinomycetales, 8 (50%) were identified by cytology and culture, 5 (31%) were identified by culture only, and 3 (19%) were identified by cytology only. Of the 129 cases of mycobacteria, 63 (49%) were identified by cytology and culture, 44 (34%) were identified by culture only, and 22 (17%) were identified by cytology only. Among the 67 cases of fungi, 34 (51%) were identified by cytology only, with 15 of these 34 cases being fungal hyphae; 25 cases (37%) were identified by cytology and culture, with a 100% concordance between the cytology diagnosis and culture result; and 8 cases (12%) were identified by culture only.
FNA cytology-culture correlation is a valuable tool with which to assess the efficacy and limitations of the direct diagnosis of infectious agents, and to identify types of infections that may be negative on culture but positive on cytology diagnosis. Cancer (Cancer Cytopathol) 2015;123:612-9. © 2015 American Cancer Society.

摘要

细针穿刺(FNA)是感染性疾病诊断的重要手段。在得到初步结果之后,细针穿刺材料应当提交培养。细胞学诊断与培养结果的相关性是重要的质控手段。本研究综述了14年的细针穿刺细胞学-培养结果间的联系。我们从记录组织学和培养结果的电子数据库中提取了1996年到2007年和2010年到2011年的细针穿刺细胞学-培养相关记录。相关性分析仅局限于那些细针穿刺样品材料提交了培养的案例。培养结果来源于实验室或者医院的信息系统。

相关性数据包括770例。其中,微生物检查细胞学阳性、培养阳性或者两者均阳性有416例(54%),排除了培养中皮肤细菌污染的病例。在204个细菌病例中,细胞学检查和培养鉴定93例(46%),培养鉴定92例(45%),细胞学检查鉴定19例(9%)。在16个放线菌目病例中,细胞学和培养鉴定8例(50%),培养鉴定5例(31%),细胞学检查鉴定3例(19%)。在分枝杆菌的129例病例中,细胞学检查和培养鉴定63例(49%),培养鉴定44例(34%),细胞学检查鉴定22例(17%)。在67例真菌病例中,细胞学检查鉴定34例(51%),其中15例有真菌菌丝;细胞学检查和培养鉴定25例(37%),细胞学诊断和培养结果之间存在100%的一致性;8例(12%)仅由培养鉴定。

细针穿刺细胞学-培养相关性是一个有用方案,可用来评估直接诊断感染性病原体时的有效性和局限性,并能确定出培养结果可能是阴性但是细胞学诊断是阳性的感染类型。



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