A superior method for cell block preparation for fine-needle aspiration biopsies.
一项用于细针穿刺活检标本细胞块制备的更佳方法
Abstract
Cell block (CB) techniques for fine-needle aspiration biopsies (FNABs) vary. A direct comparison of CB techniques with statistical validation was performed to identify the best method.
Three CB techniques were compared: 1) FNAB rinsed in saline and clotted with plasma and thrombin (SPT); 2) FNAB rinsed in formalin and clotted with HistoGel (HG); and 3) FNAB rinsed in formalin, centrifuged, and the pellet captured in a collodion bag (ColB). FNAB was performed on 35 random surgical specimens for smears and each CB technique. A randomized blinded review of hematoxylin and eosin-stained CB slides was performed and each case was scored on a scale of 1 to 3 for cellularity, preservation, and architecture and the overall best CB was identified. Significance was determined by the Mann-Whitney U test for nonparametric ordinal data.
The mean cellularity score was 1.71 for SPT (standard deviation [SD], 0.89), 1.68 for HG (SD, 0.67), and 3.0 for ColB (SD, 0). The mean preservation score was 1.31 for SPT (SD, 0.58), 1.54 for HG (SD, 0.70), and 2.91 for ColB (SD, 0.37). The mean architecture score was 1.45 for SPT (SD, 0.70), 1.43 for HG (SD, 0.60), and 2.71 for ColB (SD, 0.57). There was no statistical significance noted between SPT or HG when compared for each category. ColB was found to be superior to both SPT and HG when compared for each category (P<.05). The overall best CB was obtained with ColB in 33 of 35 cases (94%), with SPT proving superior in 1 of 35 cases (3%) and HG superior in 1 of 35 cases (3%).
ColB appears to be a superior technique for CB, yielding greater cellularity, preservation, and architecture in the majority of cases. Cancer Cytopathol 2016;124:508-18. © 2016 American Cancer Society.
Three CB techniques were compared: 1) FNAB rinsed in saline and clotted with plasma and thrombin (SPT); 2) FNAB rinsed in formalin and clotted with HistoGel (HG); and 3) FNAB rinsed in formalin, centrifuged, and the pellet captured in a collodion bag (ColB). FNAB was performed on 35 random surgical specimens for smears and each CB technique. A randomized blinded review of hematoxylin and eosin-stained CB slides was performed and each case was scored on a scale of 1 to 3 for cellularity, preservation, and architecture and the overall best CB was identified. Significance was determined by the Mann-Whitney U test for nonparametric ordinal data.
The mean cellularity score was 1.71 for SPT (standard deviation [SD], 0.89), 1.68 for HG (SD, 0.67), and 3.0 for ColB (SD, 0). The mean preservation score was 1.31 for SPT (SD, 0.58), 1.54 for HG (SD, 0.70), and 2.91 for ColB (SD, 0.37). The mean architecture score was 1.45 for SPT (SD, 0.70), 1.43 for HG (SD, 0.60), and 2.71 for ColB (SD, 0.57). There was no statistical significance noted between SPT or HG when compared for each category. ColB was found to be superior to both SPT and HG when compared for each category (P<.05). The overall best CB was obtained with ColB in 33 of 35 cases (94%), with SPT proving superior in 1 of 35 cases (3%) and HG superior in 1 of 35 cases (3%).
ColB appears to be a superior technique for CB, yielding greater cellularity, preservation, and architecture in the majority of cases. Cancer Cytopathol 2016;124:508-18. © 2016 American Cancer Society.
摘要
细针穿刺活检(FNABs)标本的细胞块(CB)有几种制备技术。本文通过统计学直接比较来确定最好的方法。将三个CB技术进行比较：
1）以盐水冲洗FNAB、血浆及凝血酶进行凝集(SPT)；
2）以福尔马林冲洗FNAB、组织胶凝集（HG）；
3）以福尔马林冲洗FNAB、离心、火棉胶袋(ColB)捕获颗粒(ColB)。
将35个随机手术标本的FNAB进行涂片和3种CB技术的制片。随机盲法评估CB玻片的HE染色，从细胞量、保存完好度和组织结构3个方面进行评分，每一项得分在1-3，选出整体得分最高的。采用Mann-Whitney U检验进行非参数检验统计学意义分析。
细胞量评分：SPT1.71(标准差(SD)，0.89)、HG1.68 (SD，0.67)、ColB3.0 (SD，0)。
保存完好度评分：SPT1.31(SD，0.58)、HG1.54 (SD，0.70)、 ColB2.91(SD,0.37)。
组织结构评分：SPT1.45(SD,0.70)、1.43 HG(SD,0.60)、ColB2.71 (SD,0.57)。
SPT与HG在各项之间的差异均没有统计学意义。ColB在各项均优于SPT和HG(P <0.05)。
35个病例的CB中，整体质量最佳的分别为ColB33例(94%)、SPT1 例(3%)、HG1 例(3%)。ColB技术在绝大多数病例的细胞量、保存完好度和组织结构上更胜一筹，是一个更加优越的CB技术。
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