Application of the International System for Serous Fluid Cytopathology in cerebrospinal fluid cytology: Overall survival analysis associated with diagnostic categories

IF 2.9 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2026-06-21 DOI:10.1002/cncy.70127

Isil Z. Yildiz Aktas MD, Baidarbhi Chakraborty MD, Jia Meng Zhang MD, Yuan Wang MD, Jocelyn Chandler MD, Carlos Mauricio Mejia Arbelaez MD, Maximilian Wegener MD, Travis Blake Fenlon DO, Abdol Aziz Ould Ismail MD, Jonathan D. Marotti MD, Zhihui Zhang MD, PhD, Xiaoying Liu MD, He Wang MD, PhD

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引用次数: 0

Abstract

Background

Cerebrospinal fluid (CSF) cytopathology lacks standardized reporting, leading to diagnostic variability and inconsistent clinical management. Although the International System for Reporting Serous Fluid Cytopathology (TIS) has been established for effusions, its utility in CSF remains underexplored. For this study, the authors applied TIS categories to CSF specimens from three academic centers across two continents and evaluated their association with overall survival (OS).

Methods

A retrospective review of pathology databases (2019–2022) across three institutions was performed. Data included demographics, cytologic diagnosis, and OS. Diagnoses were reclassified using TIS criteria. OS was analyzed using Kaplan–Meier curves and Cox proportional hazards models, and multivariable analysis was used for predictors of mortality.

Results

In total, 1137 patients underwent CSF cytologic evaluation. Diagnostic distribution was as follows: 3.2% nondiagnostic, 67.1% negative for malignancy, 6.2% atypia of undetermined significance, 2.7% suspicious for malignancy, and 20.8% malignant. Among 579 patients with follow-up, OS differed across categories (p < .001). Mean survival was longest in patients who were diagnosed as negative for malignancy (53.9 months), followed by atypia of undetermined significance (48.4 months), and suspicious for malignancy (40.3 months), and it was shortest in patients who were diagnosed with malignancy (18.7 months).

Conclusions

Leveraging a large, multi-institutional cohort with up to 5 years of follow-up, this study demonstrated that TIS categories effectively stratify CSF specimens into distinct prognostic groups. The authors identified a significant correlation between diagnostic classification and OS, with a clear decline in patient outcomes from those who had diagnoses of negative for malignancy/atypia of undetermined significance to those who had diagnoses of suspicious for malignancy and malignancy. These findings support the TIS system as a standardized, evidence-based framework that enhances risk stratification and clinical decision-making in CSF cytopathology.

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浆液细胞病理学国际系统在脑脊液细胞学中的应用：与诊断分类相关的总生存分析。

背景：脑脊液（CSF）细胞病理学缺乏标准化报告，导致诊断变异性和临床管理不一致。虽然国际浆液细胞病理学报告系统（TIS）已经建立了积液，但其在脑脊液中的应用仍未得到充分探讨。在这项研究中，作者将TIS分类应用于来自两大洲三个学术中心的CSF标本，并评估了它们与总生存率（OS）的关系。方法：对三家机构的病理学数据库（2019-2022）进行回顾性分析。数据包括人口统计学、细胞学诊断和OS。使用TIS标准对诊断进行重新分类。采用Kaplan-Meier曲线和Cox比例风险模型分析OS，采用多变量分析预测死亡率。结果：共1137例患者接受了脑脊液细胞学评估。诊断分布如下：非诊断性3.2%，恶性阴性67.1%，意义不明的异型性6.2%，可疑恶性2.7%，恶性20.8%。在579名随访患者中，不同类别的OS不同(p)。结论：利用长达5年随访的大型多机构队列，该研究表明，TIS类别有效地将CSF标本分层为不同的预后组。作者确定了诊断分类与OS之间的显著相关性，从诊断为恶性肿瘤/不确定意义的非典型性阴性的患者到诊断为可疑恶性肿瘤和恶性肿瘤的患者，其预后明显下降。这些发现支持TIS系统作为一个标准化的、基于证据的框架，可以增强CSF细胞病理学的风险分层和临床决策。

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.