Value and limitations of cytologic criteria for the diagnosis of hepatocellular carcinoma by fine needle aspiration biopsy

Solé, M.; Calvet, X.; Cuberes, T.; Maderuelo, F.; Bruix, J.; Bru, C.; Rey, M.J.; Serna, N.; Cardesa, A.

Acta Cytologica 37(3): 309-316

1993


ISSN/ISBN: 0001-5547
PMID: 8388606
Document Number: 406794
In order to further evaluate the utility of fine needle aspiration biopsy (FNAB) cytology for the diagnosis of hepatocellular carcinoma (HCC), we analyzed 39 cytologic features in a series of 102 FNABs from HCC and compared them with 28 FNABs from nonneoplastic conditions. Thirteen features were significantly associated with HCC; from them a stepwise logistic regression analysis selected the three most predictive: irregular arrangement, irregular chromatin pattern and uniformly smaller cytoplasm, the last two found only in HCC. Using different specific combinations of significant cytologic features, the highest sensitivity obtained was 84.3%, with 100% specificity. Sixteen HCC cases could not be diagnosed specifically using the criteria defined in this study, probably due to their well-differentiated nature or to sampling error. Although the use of additional techniques, such as cell block preparations, would improve the results in well-differentiated tumors, we recommend basing the early diagnosis of small HCC on a multidisciplinary approach.

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