The Usefulness of $SurePath^{TM}$ Liquid-Based Smear in Sono-Guided Thyroid Fine Needle Aspiration; a Comparison of a Conventional Smear and $SurePath^{TM}$ Liquid-Based Cytology

초음파 유도 갑삼샘 세침흡인 세포검사에서 $SurePath^{TM}$ 액상세포검사의 유용성; 고식적 도말검사와 $SurePath^{TM}$ 액상세포검사와의 비교

  • Kim, Dong-Hoon (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Min-Kyung (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chae, Seoung-Wan (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Kyoung-Bun (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Han, Eun Mee (Department of Pathology, Pundang Jesaeng General Hospital) ;
  • Kang, Sung-Hee (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Sohn, Jin-Hee (Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 김동훈 (성균관의대 강북삼성병원, 병리과) ;
  • 김민경 (성균관의대 강북삼성병원, 병리과) ;
  • 채승완 (성균관의대 강북삼성병원, 병리과) ;
  • 이경분 (성균관의대 강북삼성병원, 병리과) ;
  • 한은미 (분당제생병원, 병리과) ;
  • 강성희 (성균관의대 강북삼성병원, 병리과) ;
  • 손진희 (성균관의대 강북삼성병원, 병리과)
  • Published : 2007.09.30

Abstract

Sono-guided fine needle aspiration (FNA) of the thyroid is widely used, but the aspirated samples are typically not well preserved and low cellularity makes diagnosis difficult in many cases. The object of the current study is to evaluate the adequacy and diagnostic accuracy of the use of $SurePath^{TM}$ liquid-based cytology (SP-LBC) in the sonoguided fine needle aspiration of the thyroid nodule and to compare its use with that of the use of a conventional smear (CS). A total of 172 sono-guided FNAs of thyroid nodules from April to June, 2006 were prepared by the use of the split method with either SP-LBC or CS; the samples were stained with the use of hematoxylin-eosin (H&E) and Papanicolaou (Pap) stains. A cyto-histological correlation was performed in 69 (30 SP and 39 CS) cases that had been histologically confirmed. The rate of producing unsatisfactory slides by the use of the SP-LBC method (9.3%) was less than that of the use of the CS method (20.9%). The diagnostic accuracy of the SP method (93.3%) was better than that of the CS method (85.3%). The sensitivity and specificity of the SP method (94.4% and 92.3%) was better than that of the CS method (83.3% and 70%), respectively (p < 0.05). The CS of sono-guided aspirated specimens had some unavoidable limitations related to inadequate sampling such as a bloody background, low cellularity and an indication that some clinicians smeared many useless slides (averaging four to ten slides), and that most slides showed only blood that included few follicular cells. The SP method resulted in more thinly smeared slides and showed cleaner background and greater cellularity than the use of the CS method. Each follicular cell shows superior nuclear detail, and more distinct cytoplasmic features than with the use of the CS method. SP-LBC appears to be an easy, highly accurate, and reliable cytological method for employ for a diagnostic approach of thyroid disease and thyroid nodules. The SP-LBC method is a suitable alternative to the CS method to overcome diagnostic difficulties.

Keywords

References

  1. Afify AM, Liu J, Al-Khafaji BM. Cytologic artifacts and pitfalls of thyroid fine-needle aspiration using ThinPrep: a comparative retrospective review. Cancer 2001;93:179-86 https://doi.org/10.1002/cncr.9027
  2. Frost AR, Sidawy MK, Ferfelli M, et al. Utility of thin-layer preparations in thyroid fine-needle aspiration: diagnostic accuracy, cytomorphology, and optimal sample preparation. Cancer 1998;84:17-25 https://doi.org/10.1002/(SICI)1097-0142(19980225)84:1<17::AID-CNCR4>3.0.CO;2-C
  3. Zhang Y, Fraser JL, Wang HH. Morphologic predictors of papillary carcinoma on fine-needle aspiration of thyroid with ThinPrep preparations. Diagn Cytopathol 2001;24:378-83 https://doi.org/10.1002/dc.1084
  4. Scurry JP, Duggan MA, Thin layer compared to direct smear in thyroid fine needle aspiration. Cytopathology 2000;11:104-15 https://doi.org/10.1046/j.1365-2303.2000.00228.x
  5. Cochand-Priollet B, Guillausseau PJ, Chagnon S, et al. The diagnostic value of fine-needle aspiration biopsy under ultrasonography in nonfunctional thyroid nodules: a prospective study comparing cytologic and histologic findings. Am J Med 1994;97:152-7 https://doi.org/10.1016/0002-9343(94)90025-6
  6. Cochand-Priollet B, Prat JJ, Polivka M, et al. Thyroid fine needle aspiration: the morphological features on $ThinPrep^{(R)}$ slide preparations. Eighty cases with histologic control. Cytopathology 2003;14:343-9 https://doi.org/10.1046/j.0956-5507.2003.00098.x
  7. Park JM, Jang JW, Lim SY, Lee JG, Suh IS. Evaluation of the manual method of liquid-based uterine cervicovaginal cytology - by the manual method based on $SurePath^{TM}$ methodology. Korean J Cytopathol 2004;15:86-91
  8. Colgan TJ, McLachlin CM, Cotterchio M, Howlett R, Seidenfeld AM, Mai VM. Results of the implementation of liquid-based cytology-Surepath in the Ontario screening program. Cancer 2004;102:362-7 https://doi.org/10.1002/cncr.20656
  9. Fremont-Smith M, Marino J, Griffin B, Spencer L, Bolick D. Comparison of the SurePath liquid-based Papanicolaou smear with the conventional Papanicolaou smear in a multisite direct-to-vial study. Cancer 2004;102:269-79 https://doi.org/10.1002/cncr.20599