[Evaluation of the diagnostic significance of cytologic studies in pancreatic tumors].

The study was undertaken to specify cytomorphological criteria for prostatic duct adenocarcinoma (PDAC), by assessing fine-needle aspiration biopsy (FNAB) specimens. Histologically verified cases were selected and the archival cytological material that constituted Leishman stained smears obtained by percutaneous FNAB under ultrasound guidance from 72 patients with PDAC (n = 50) or ductal hyperplasia (DP) (n = 22) was revised. For statistical analysis, the authors selected the following cytological signs of malignancy: anisonucleosis, increased nuclei, hyperchromia, uneven chromatin distribution, enucleation, uneven nuclear outline, apocytes; increased nucleoli, nucleolar polymorphism, multiple nucleoli, increased cells, anisocytosis (polymorphism of the size and shape of a cell, mitoses, piled nuclei, papillary structures, slightly glandular structures. The statistical analysis identified three most important cytological criteria for PDAC: anisocytosis, anisonucleosis, and piled nuclei. Keeping in mind all three signs at once increases the probability of detecting of PDAC up with 90%. The detection of only anisocytosis in the cytological specimen showed a 40% probability of the presence of PDAC. Three additional cytological signs of PDAC were also identified: increased nuclei, uneven nuclear outline, and slightly adhesive structures. The probability of PDAC was 100% if the specimen contained three most significant signs and any of the additional signs. By taking into account the indicators of diagnostic efficiency (DE), the best criteria were as follows: anisonucleosis, uneven nuclear outline, anisocytosis. The optimal indicators of DE for anisonucleosis were 95.83% diagnostic sensitivity (DSen), 95.83% diagnostic specificity (DSp), and 95.83% DE. When two indicators (anisonucleosis and uneven nuclear outline) were simultaneously used, DSen was 93.42; DSp, 98.53% (the highest); DE, 95.83%. Thus, the following cytological signs are defined as important for differentiation of PH and PDAC: anisocytosis, anisonucleosis, piled nuclei, increased nuclei, uneven nuclear outline, slightly adhesive structures.

[Differential diagnosis of hepatocellular carcinoma using laser DNA-cytofluorometry]. / Differentsial'no-diagnosticheskie kriterii gepatotselliuliarnogo raka, opredelennye metodom lazernoi DNK-protochnoi tsitofliuorometrii.

Because of insufficient amount of material obtained in many cases of puncture biopsy, Differential diagnosis of hepatocellular carcinoma (HCC) with benign tumors and focal cirrhotic lesions of the liver is difficult. The study was aimed at development of additional criteria for HCC differential diagnosis of the basis of a comparison of morphological data (histological and cytological) with DNA content in the cells of focal lesion of the liver and is based on the research of biopsy material from 111 patients with focal liver lesions. Laser DNA flow cytometry (DNA-FCM) was carried out in 59 samples using laser flowing cytometer FACScan (Becton Dickinson, USA). The complex of three HCC histological criteria was established (trabecular histoarchitecture, increased nuclear-cytoplasmatic rate and nuclear crowding) for comparison with puncture biopsy of the liver (diagnostic efficiency 93.7%). Optimal quantitative parameters for HCC diagnosis were the following: reduction of the number of cells in a GO/1 phase of the cell cycle (< 77.5%), appearance of aneuploid clone of cell DNA index > 1.0 and decreased percent of binucleated cells (< 10%). Very high diagnostic specificity of the research was found (98.3%). Usage of quantitative parameters in the complex with histological criteria of HCC increased efficiency of the diagnosis up to 98%.