Cellular cohesiveness in benign and XXXX varies significantly, but the difference is not useful in diagnosis of individual cases.

@entity1 @entity5 @entity19 @entity5962 @entity189 @entity652 @entity259
INTRODUCTION: The aim of our study was to search for new, readily available and statistically reliable cytological markers for differentiating benign and @entity259 pre-operatively. METHODS: Cohesiveness of @entity5 cells in cytology slides from a series of 58 follicular @entity5 diagnosed between 1998 and 2004 inclusive was studied, including 48 @entity652 , and eight minimally invasive and two widely invasive @entity189 . Photomicrographs of the cytology slides were taken and the digital images were analysed using computer image analysis software. We evaluated the relative proportions of cells arranged in groups of various sizes. The cohesiveness of the cells in cytological smears was then correlated with the immunohistochemical expression of @entity5962 in corresponding histological slides. RESULTS: Cases from 15 @entity1 (26%) and 43 @entity1 (74%) with a mean age of 50 years (range, 19-79) were analysed. In @entity652 and @entity189 , respectively, isolated cells were seen in 16.8% and 24.7% (P = 0.028), groups of two to five cells in 9.7% and 11.5% (P = 0.145) and groups of more than five cells in @entity19 % and 63.8% (P = 0.041). The mean cell count in groups with more than five cells was 46.5 and 27.0 in @entity652 and @entity189 , respectively (P < 0.001). Cell cohesiveness, either as percentage of cells in groups of more than five (R(2) = 0.026) or as mean cell count per group of more than five (R(2) = 0.005), was not found to be dependent on the expression of @entity5962 . Using a threshold of 13% @entity5 cells in cytological smears, @entity652 and @entity189 could be distinguished with 90% sensitivity and 41% specificity. CONCLUSIONS: Although we demonstrated a statistically significant difference in cell cohesion between @entity652 and @entity189 , these could not be distinguished in the clinical setting by evaluation of the percentage of isolated cells in cytological smears because the specificity was too low. The absence of correlation of cellular cohesiveness with @entity5962 expression indicates that other factors are probably responsible for the loss of cohesiveness observed in follicular thyroid malignancy.
