Cell block specimens applied to diagnostic routine of thyroid fine-needle aspiration biopsy

ABSTRACT Introduction: Various preparations can be used in diagnostic cytology, including conventional smears (CS), liquid-based preparations (LBP) and cell block (CB). Objective: The aim of this study is to evaluate the quality of CB preparations in addition to conventional cytological specimens in cases of fine-needle aspiration biopsy (FNAB) of thyroid nodules in diagnostic routine. Method: One hundred and six consecutive cases of FNAB routine thyroid nodules were independently evaluated by two cytopathologists (Obs1 and Obs2) on the cellularity of SM, LBP and CB. Results: The cellularity was rich/moderate in 56 (52.8%) CBs for both observers. LBP showed rich/moderate cellularity in 86 (81.1%) cases for Obs1 and 91 (85.8%) for Obs2; among these cases, CB showed the same cellularity in 52/86 (60.4%) cases for Obs1 and 54/91 (59.3%) for Obs2. SM showed rich/moderate cellularity in 86 (81.1%) cases for Obs1 and 87 (82%) for Obs2; among these cases, CB showed the same cellularity in 48/86 (55.8%) cases for Obs1 and 54/87 (62%) for Obs2. CB cellularity was higher than that in LBP in only five cases for Obs1 and three for Obs2. LBP was assessed as low/absent in only five (4.7%) and six (5.6%) cases for Obs1 and Obs2, respectively. Conclusion: CB can be routinely used as additional specimen in material obtained from thyroid nodules FNAB, without adversely affecting LBP specimens, enabling the conduction of further immunohistochemical and molecular studies.

摘要
引言：诊断细胞学可采用多种制片方式，包括常规涂片（conventional smears, CS）、液基制片（liquid-based preparations, LBP）与细胞蜡块（cell block, CB）。
研究目的：本研究旨在评估甲状腺结节细针穿刺活检（fine-needle aspiration biopsy, FNAB）日常诊断工作中，在常规细胞学标本基础上额外添加细胞蜡块制片的诊断质量。
方法：收集106例连续纳入的甲状腺结节细针穿刺活检常规病例，由两位细胞病理医师（Obs1与Obs2）分别对常规涂片、液基制片及细胞蜡块的细胞丰富度进行独立评估。
结果：两位医师均判定56例（52.8%）细胞蜡块的细胞丰富度为丰富/中等。液基制片中，Obs1评估出86例（81.1%）为丰富/中等细胞丰富度，Obs2为91例（85.8%）；其中，Obs1对应的52/86（60.4%）病例、Obs2对应的54/91（59.3%）病例，细胞蜡块与液基制片的细胞丰富度一致。常规涂片方面，Obs1评估86例（81.1%）为丰富/中等细胞丰富度，Obs2为87例（82%）；其中，Obs1对应的48/86（55.8%）病例、Obs2对应的54/87（62%）病例，细胞蜡块与常规涂片的细胞丰富度一致。仅5例（Obs1）与3例（Obs2）的细胞蜡块细胞丰富度高于液基制片。液基制片仅分别有5例（4.7%）与6例（5.6%）被两位医师评估为细胞稀少/无细胞。
结论：甲状腺结节细针穿刺活检获取的标本中，细胞蜡块可作为额外制片常规应用，不会对液基制片标本产生不良影响，同时可支持后续免疫组化及分子检测的开展。