Assessment of risk of malignancy with application of Sydney classification for reporting of lymph node cytopathology in pediatric population: An institutional experience

IF 2.6 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2025-02-04 DOI:10.1002/cncy.22936

Mukund Sable MD, Manisha Panda MBBS, Prapti Acharya MD, Pritinanda Mishra MD, Suvendu Purkait MD, Madhusmita Sethy MD, Pavithra Ayyanar MD, Amit Kumar Adhya MD, Susama Patra MD

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引用次数: 0

Abstract

Background

Fine-needle aspiration cytology (FNAC) has been used as the first line approach to lymphadenopathy, which is a common presentation in pediatric age group. The Sydney system for reporting of lymph node (LN) cytology has been proposed to assess the reliability, performance, and accuracy of the aspiration procedure. This study intends to assess the role of FNAC in the pediatric population according to the Sydney system.

Methods

This was a retrospective observational study from a tertiary care center in Eastern India. All the patients in the age group of 0–18 years evaluated during years 2016–2024 were reclassified according to the Sydney system. Based on the cytology and histology diagnoses, the cases were categorized into true-negative, true-positive, false-negative, and false-positive. The overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and risk of malignancy (ROM) was calculated for each category.

Results

Of 803 cases of pediatric LN-FNACs, 35 (4.35%) cases were reported as inadequate (L1), 689 (85.8%) cases as benign (L2), four (0.49%) cases as atypical cells of undetermined significance (L3), 22 cases as suspicious for malignancy (L4), and 53 (6.6%) cases as malignant (L5). The sensitivity, specificity, PPV, NPV, and accuracy was 72.34%, 98.48%, 97.14%, 83.33%, and 87.61%, respectively. The ROM was 16.67% for L2 and 100% for both L4 and L5 categories.

Conclusions

FNAC is a highly accurate and specific test for LN pathology, especially in the pediatric population. The incorporation of the Sydney system helps to achieve uniformity and reproducibility in LN cytology diagnosis.

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应用悉尼分类报告儿科人群淋巴结细胞病理学的恶性肿瘤风险评估：一个机构经验

背景：细针穿刺细胞学检查（FNAC）已被用作治疗淋巴结病的一线方法，这是儿科年龄组的常见表现。淋巴结（LN）细胞学报告的Sydney系统已被提议用于评估抽吸过程的可靠性、性能和准确性。本研究旨在根据悉尼系统评估FNAC在儿科人群中的作用。方法：本研究是一项来自印度东部三级保健中心的回顾性观察性研究。所有在2016-2024年评估的0-18岁年龄组的患者根据悉尼系统重新分类。根据细胞学和组织学诊断，将病例分为真阴性、真阳性、假阴性和假阳性。计算每个类别的总体敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、准确性和恶性肿瘤风险（ROM）。结果803例小儿LN-FNACs中，35例（4.35%）为不充分（L1）， 689例（85.8%）为良性（L2）， 4例（0.49%）为意义不明的非典型细胞（L3）， 22例（L4）为可疑恶性（L5）， 53例（6.6%）为恶性（L5）。灵敏度为72.34%，特异度为98.48%，PPV为97.14%，NPV为83.33%，准确率为87.61%。L2的ROM为16.67%，L4和L5的ROM均为100%。结论FNAC是一种高度准确和特异性的LN病理检测方法，特别是在儿科人群中。悉尼系统的合并有助于实现LN细胞学诊断的一致性和可重复性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.