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Abstract：
Background and Objectives: This study aimed to elucidate the cytologic characteristics and diagnostic usefulness of endoscopic ultrasonography-fine needle aspiration cytology (EUS-FNAC) by comparing it with liquid-based preparation (LBP) and conventional smear (CS) in pancreas. Methods: The diagnostic categories (I through VII) were classified according to the World Health Organization Reporting System for Pancreaticobiliary Cytopathology. Ten cytologic features, including nuclear and additional features, were evaluated in 53 cases subjected to EUS-FNAC. Nuclear features comprised irregular nuclear contours, nuclear enlargement, hypochromatic nuclei with parachromatin clearing, and nucleoli. Additional cellular features included isolated atypical cells, mucinous cytoplasm, drunken honeycomb architecture, mitosis, necrotic background, and cellularity. A decision tree analysis was conducted to assess diagnostic efficacy. Results: The diagnostic concordance rate between LBP and CS was 49.1% (26 out of 53 cases). No significant differences in nuclear features were observed between categories III (atypical), VI (suspicious for malignancy), and VII (malignant). The decision tree analysis of LBP indicated that cases with moderate or high cellularity and mitosis could be considered diagnostic for those exhibiting nuclear atypia. Furthermore, in CS, mitosis, isolated atypical cells, and necrotic background exerted a more significant impact on the diagnosis of EUS-FNAC. Conclusions: Significant parameters for interpreting EUS-FNAC may differ between LBP and CS. While nuclear atypia did not influence the diagnosis of categories III, VI, and VII, other cytopathologic features, such as cellularity, mitosis, and necrotic background, may present challenges in diagnosing EUS-FNAC.
摘要：
背景和目的：本研究旨在通过与胰腺中的液基制剂（LBP）和常规涂片（CS）进行比较，来阐明超声内镜-细针穿刺细胞学（EUS-FNAC）的细胞学特征和诊断价值。方法：根据世界卫生组织胰胆管细胞病理学报告系统对诊断类别（I至VII）进行分类。十个细胞学特征，包括核和附加功能，对53例接受EUS-FNAC的病例进行了评估。核特征包括不规则的核轮廓，核扩大,带副染色质清除的低染色核，和核仁.其他细胞特征包括分离的非典型细胞，粘液质，醉酒的蜂窝状建筑，有丝分裂,坏死背景，和细胞性。进行决策树分析以评估诊断效能。结果：LBP与CS的诊断符合率为49.1%（53例中有26例）。在III类（非典型）之间没有观察到核特征的显着差异，VI（可疑恶性肿瘤），和VII（恶性）。LBP的决策树分析表明，具有中度或高度细胞性和有丝分裂的病例可被认为是表现出核异型性的病例的诊断。此外，在CS中,有丝分裂,分离的非典型细胞，坏死背景对EUS-FNAC的诊断有更显著的影响。结论：LBP和CS之间解释EUS-FNAC的重要参数可能有所不同。虽然核异型不影响III类的诊断，VI,VII,其他细胞病理学特征，比如细胞数量，有丝分裂,坏死的背景，在诊断EUS-FNAC方面可能存在挑战。
