The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities
The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities
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DOI：
10.1002/dc.24036
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发表时间：
2018-09-01
影响因子：
1.3
通讯作者：
Schmitt, Fernando
中科院分区：
文献类型：
--
作者：
Canberk, Sule;Montezuma, Diana;Schmitt, Fernando
背景方法2016年，巴帕尼科拉乌细胞病理学会（PSC）发布了一项新的呼吸道细胞学分类方案。我们的目的是根据这种分类来评估我们的样本，并评估恶性肿瘤的风险和不同细胞学模式的诊断率。根据PSC指南对2007年至2016年期间获得的呼吸道标本（痰液，支气管冲洗液/刷，BAL和FNA）进行重新分类。确定每个诊断类别的恶性肿瘤风险。诊断率进行了评估的基础上三个分类approach.ResultsConclusion1000，200和90呼吸道标本被检索，其中280个组织学随访。样本被重新分类为非诊断性16%，恶性阴性53%，非典型5.4%，肿瘤性（良性肿瘤/低级别癌）0.4%，可疑恶性2.1%和恶性23.1%。各分类的恶性风险分别为ND 64.01%、NM 48.27%、A 59.09%、N-B-LG 100%、SM 90%、M 89.74%。当仅恶性肿瘤为阳性时，细胞学检查的敏感性为55%，特异性为88%，2组结果均符合PSC指南，但由于不同细胞学检查方法的广泛应用，多种细胞学检查方法的综合诊断率和恶性肿瘤风险估计值可能存在差异。
BackgroundMethodsIn 2016, the Papanicolaou Society of Cytopathology (PSC) issued a new classification scheme for respiratory cytology. We aim to evaluate our samples according to this classification and to assess risk of malignancy and diagnostic yield of different cytological modalities.Respiratory specimens (sputum, bronchial wash/brush, BAL and FNA) obtained between 2007 and 2016 were reclassified according to PSC guidelines. Risk of malignancy for each diagnostic category was determined. Diagnostic yield was evaluated based on three-categorical approach.ResultsConclusionOne thousand, two hundred and ninety respiratory specimens were retrieved, of which 280 had histologic follow-up. Samples were reclassified as nondiagnostic 16%, negative for malignancy 53%, atypical 5.4%, neoplastic (benign neoplasm/low-grade carcinoma) 0.4%, suspicious for malignancy 2.1% and malignant 23.1%. Risk of malignancy for each category was 64.01% for ND, 48.27% for NM, 59.09% for A, 100% for N-B-LG; 90% for SM and 89.74% for M. When only malignant cases were considered positive tests, cytology sensitivity was 55% and specificity 88%.Our results were in line with PSC guidelines, but the use of multiple cytological techniques may cause some discrepancies in overall diagnostic yield and in estimated risks of malignancy, which is important due to the widespread utilization of different cytological procedures.