PSC及WHO胰胆管细胞学报告系统在胰腺肿物诊断中的应用

Application of PSC and WHO reporting system for pancreaticobiliary cytopathology in diagnosis of pancreatic masses

目的探讨Papanicolaou细胞病理学会(PSC)及世界卫生组织(WHO)胰胆管细胞学报告系统在胰腺肿物诊断中的应用。方法回顾411例胰腺超声内镜引导下细针穿刺细胞学(EUS-FNAC),根据PSC及WHO进行分级,并与组织病理对比分析。结果根据PSC,18例(4.4%)诊断为Ⅰ级;155例(37.7%)诊断为Ⅱ级;32例(7.8%)诊断为Ⅲ级;64例(15.6%)诊断为Ⅳ级(其中ⅣA级14例,ⅣB级50例);51例(12.4%)诊断为Ⅴ级;91例(22.1%)诊断为Ⅵ级。根据WHO:Ⅰ-Ⅲ级病变分类与PSC分类一致;14例(3.4%)诊断为Ⅳ级;39例(9.4%)诊断为Ⅴ级;51例(12.4%)诊断为Ⅵ级;102例(24.9%)诊断为Ⅶ级。FNAC对胰腺肿瘤诊断准确率为95.7%(376/393),敏感性为96.5%(196/203),特异性为94.7%(180/190)。结论PSC和WHO胰胆管细胞学报告可以与临床医生进行有效的交流。

Objective To explore the application of Papanicolaou Society of Cytopathology( PSC) and World Health Organization( WHO) reporting system for pancreaticobiliary cytopathology in the diagnosis of pancreatic masses.Methods This paper reviewed 411 cases of pancreatic endoscopic ultrasound guided fine needle aspiration cytopathology(EUS-FNAC). According to the pancreaticobiliary cytology reporting system issued by PSC and WHO, the cytological and pathological reports were classified for diagnosis and compared with the result of histopathological examination. Results According to the PSC reporting system, 18(4. 4%) were diagnosed as grade Ⅰ;155 cases(37. 7%) were diagnosed as grade Ⅱ;32 cases(7. 8%) were diagnosed as grade Ⅲ;64 cases(15. 6%) were diagnosed as grade Ⅳ(including 14cases of ⅣA grade and 50 cases of ⅣB grade);51 cases(12. 4%) were diagnosed as grade Ⅴ;91 cases(22. 1%) were diagnosed as grade Ⅵ. According to the WHO reporting system, the classification of I-Ⅲ lesions was consistent with the PSC classification;14 cases(3. 4%) were diagnosed as grade Ⅳ;39 cases(9. 4%) were diagnosed as grade Ⅴ;51 cases(12. 4%) were diagnosed as grade Ⅵ;102 cases(24. 9%) were diagnosed as grade Ⅶ. Compared with the result of histopathological examination, the accuracy of FNAC in the diagnosis of pancreatic tumors was 95. 7%( 376/393),sensitivity was 96. 5%(196/203), and specificity was 94. 7%(180/190). There was no difference in the accuracy and specificity of tumor diagnosis between PSC and WHO.pancreaticobiliary cytopathology can effectively communicate with clinical doctors.