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  • Title: Value and limitations of cytologic criteria for the diagnosis of hepatocellular carcinoma by fine needle aspiration biopsy.
    Author: Solé M, Calvet X, Cuberes T, Maderuelo F, Bruix J, Bru C, Rey MJ, Serna N, Cardesa A.
    Journal: Acta Cytol; 1993; 37(3):309-16. PubMed ID: 8388606.
    Abstract:
    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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