Introduction: This study aimed to clarify the diagnostic structural features in cytology specimens that are useful in subtyping non-small cell lung carcinoma (NSCLC) into adenocarcinoma (ADC) and squamous cell carcinoma (SQCC). Methods: Cytology specimens (n = 233) of NSCLCs, which included ADCs (n = 149) and SQCCs (n = 84), were analyzed. The following cytological features were evaluated: isolated cell, flat sheet, three-dimensional cluster with irregular arrangement, papillary-like structure, micropapillary-like structure, acinar-like structure, palisading pattern, protrusion of nuclei at the periphery of the cluster, honeycomb pattern, streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion. Results: ADCs exhibited significantly higher frequencies of flat sheet (p < 0.001), papillary-like structure (p < 0.001), micropapillary-like structure (p = 0.028), acinar-like structure (p < 0.001) and protrusion of nuclei at the periphery of the cluster (p < 0.001) than SQCCs. The latter exhibited significantly higher frequencies of streaming arrangement (p < 0.001), three-dimensional sheets with regular arrangement (p < 0.001), flattening at the periphery of the cluster (p < 0.001), fuzzy pattern at the periphery of the cluster (p < 0.001), and mutual inclusion (p < 0.001) than ADCs. Discussion/Conclusion: Cytological structural features, such as flat sheet, papillary-like structure, micropapillary-like structure, acinar-like structure, and protrusion of nuclei at the periphery of the cluster, indicated ADC, whereas streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion indicated SQCC. Paying attention to these cytological structural features can enable the accurate subtyping of NSCLC into ADC and SQCC.


中文翻译：

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根据细胞学结构特征将非小细胞肺癌分为腺癌和鳞状细胞癌

简介：本研究旨在阐明细胞学标本的诊断结构特征，这些特征有助于将非小细胞肺癌 (NSCLC) 分为腺癌 (ADC) 和鳞状细胞癌 (SQCC)。方法：分析了 NSCLC 的细胞学标本（n = 233），其中包括 ADC（n = 149）和 SQCC（n = 84）。评估以下细胞学特征：孤立细胞、平板、不规则排列的三维簇、乳头状结构、微乳头状结构、腺泡状结构、栅栏图案、簇周围细胞核突出、蜂窝状图案、流式排列、规则排列的三维片、簇外围平坦化、簇外围模糊图案、相互包含。结果：ADC 在以下位置表现出明显较高的扁平片状结构 (p < 0.001)、乳头状结构 (p < 0.001)、微乳头状结构 (p = 0.028)、腺泡状结构 (p < 0.001) 和细胞核突出的频率簇的外围 (p < 0.001) 高于 SQCC。后者表现出明显较高的流式排列频率（p < 0.001）、规则排列的三维片状（p < 0.001）、簇外围扁平化（p < 0.001）、簇外围模糊图案（ p < 0.001)，并且与 ADC 相比，互包含 (p < 0.001)。讨论/结论：细胞学结构特征，如扁平片状、乳头状结构、微乳头状结构、腺泡状结构、簇外围核突出等，表示ADC，而流式排列，三维片状排列规则、簇外围平坦、簇外围模糊、互包含表示SQCC。关注这些细胞学结构特征可以将 NSCLC 准确分型为 ADC 和 SQCC。