Touch Imprint Cytology in the Diagnosis of Nasopharyngeal Carcinoma - A Preliminary Report

細胞印片應用於鼻咽癌的診斷－初步報告

王智弘(Chih-Hung Wang) ； 林烱堃(John K. Lin) ； 曹唐義(Tang-Yi Tsao) ； 趙祖怡(Tsu-Yi Chao)

《中華民國耳鼻喉科醫學會雜誌》 30卷4期 (1995/08) Pp. 358-365

https://doi.org/10.6286/1995.30.4.358

摘要

過去利用細胞剝落方式的細胞學檢查來診斷鼻咽癌，由於診斷率低，目前已很少被使用，其原因與鼻咽部位的細胞採集方法不盡理想有關。三軍總醫院耳鼻喉部與血液腫瘤科於民國83年1月至9月間，對42名疑似鼻咽癌的患者，於門診接受鼻咽部位切片檢查的同時，利用其標本製作成細胞印片，待自風乾並以Quick-Diff stain 加以染色，隨即以光學顯微鏡進行判讀。結果顯示細胞印片對於鼻咽癌診斷的敏感度高達93.3%(14/15)，特異度為92.6%(25/27)，假陽性率為7.4%(2/27)，假陰性率為6.7%(1/15)，對於鼻咽癌之陽性預測值約為87.5%(14/16)，陰性之預測值為96.2%(25/26)。由本研究之結果可發現，如能改變鼻咽部位細胞採集的方法，細胞印片之細胞學檢查是診斷鼻咽癌的一項有效、簡單且快速的診斷工具，其高達93.3%的診斷率，更可用來輔助及支持組織病理切片的判讀結果。

並列摘要

Background Exfoliative cytology is not currently used in the diagnosis of nasopharyngeal carcinoma (NPC) because of its low diagnostic rate. Methods for collecting cells from the nasopharyngeal (NP) region is an important factor which can influence the diagnostic yield. We proposed that cytologic examination of touch-imprinted smears from NP biopsies can improve the diagnostic rate of cytology.
Methods Touch-imprinted smears were made from NP-biopsied specimens from patients suspicious of NPC. After air-dried and stained with Quick-Diff stain, morphologic diagnosis was made immediately and the results were grouped to positive-, negative- or suspicious for NPC. For suspicious group, immunocytochemical staining with CD45 and cytokeratin (CK) as markers were performed to ensure the nature of cells. Histologic examinations of the biopsied specimens were served as controls.
Results From January through September 1994, 42 patients were recruited into this study. Morphologically, 15 of them were positive, 25 were negative, and 2 were suspicious for NPC. One of the 2 suspicious cases was found to be malignant by demonstrating CK (+) and CD45 (─) in suspicious cells, the other benign by showing CD45 (+) and CK (─) in suspicious cells. Histologically, 15 patients were NPC and 27 were either lymphoid hyperplasia or chronic inflammation. The sensitivity and specificity were 93.3% and 92.6% respectively. Positive and negative predicting value were 87.5% and 96.2% respectively.
Conclusions We concluded that touch imprint cytology is a useful and valuable aid in diagnosing NPC. It is a rapid, accurate method and can ensure that the biopsy has been successfully done.

並列關鍵字

Nasopharyngeal carcinoma, touch imprint, cytologic diagnosis