Acta Cytologica最新文献

From Cells to Targeted Therapy: Cytopathology as the Starting Point of Precision Oncology in the Molecular Tumor Board Workflow. 从细胞到靶向治疗：细胞病理学作为分子肿瘤委员会工作流程中精确肿瘤学的起点。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-05-08 DOI: 10.1159/000552314

Ricella Souza da Silva, Fernando C Schmitt

{"title":"From Cells to Targeted Therapy: Cytopathology as the Starting Point of Precision Oncology in the Molecular Tumor Board Workflow.","authors":"Ricella Souza da Silva, Fernando C Schmitt","doi":"10.1159/000552314","DOIUrl":"https://doi.org/10.1159/000552314","url":null,"abstract":"Precision oncology is often portrayed as a story of genes and drugs, yet it begins with a cell on a slide. This paper positions cytopathology as the front door to Molecular Tumor Boards (MTBs), showing how minimally invasive specimens can reliably be a source for comprehensive genomic profiling and guide targeted therapy decisions. We summarise current evidence and international recommendations to outline a practical MTB workflow, from case selection and sample triage to technical and clinical validation of molecular alterations, structured reporting, and outcome monitoring. Emphasis is placed on pre-analytic variables and cytomorphologic assessment as determinants of next-generation sequencing success, as well as on the use of cytology-derived preparations, such as cell blocks, smears, body fluids, and supernatants, as site-specific \"liquid biopsies\", for example from CSF in advanced tumours and as alternative to surgical biopsy in some cases. We also discuss some operational bottlenecks and discuss how integrative pathology, can enhance MTB efficiency. Integrating cytopathology samples into MTB workflows, is increasingly recognized as a viable strategy to clinical decision-making using minimally invasive specimens. This integrative approach finds its most dynamic expression in the redefinition of the Molecular Tumor Board.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Discard to Discovery: Leveraging Residual Cytology Fine Needle Aspiration Supernatants for Rapid EGFR and KRAS Mutation Detection in Lung Cancer. 从丢弃到发现：利用残余细胞学细针抽吸上清快速检测肺癌中EGFR和KRAS突变。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-05-02 DOI: 10.1159/000552356

Margaret Parham, Saroja Devi Geetha, David E Ost, Sravanthi Lavu, Gloria Hopkins Sura

{"title":"From Discard to Discovery: Leveraging Residual Cytology Fine Needle Aspiration Supernatants for Rapid EGFR and KRAS Mutation Detection in Lung Cancer.","authors":"Margaret Parham, Saroja Devi Geetha, David E Ost, Sravanthi Lavu, Gloria Hopkins Sura","doi":"10.1159/000552356","DOIUrl":"https://doi.org/10.1159/000552356","url":null,"abstract":"Introduction: Timely molecular testing is essential for guiding targeted therapy in non-small cell lung cancer (NSCLC), yet results are often delayed by limited tissue availability and reliance on formalin-fixed, paraffin-embedded (FFPE) material for next-generation sequencing (NGS). Cytology fine-needle aspiration (FNA) specimens frequently provide the sole diagnostic sample, and their residual supernatants-typically discarded-represent an untapped source of tumor-derived nucleic acids.Methods: In this pilot study, cytology supernatants from 10 NSCLC cases with known EGFR or KRAS mutations by NGS were analyzed using Idylla™ ctEGFR and ctKRAS Mutation Assays. Each 2-3 mL supernatant sample, stored in CytoLyt® at 4 °C after cell block preparation, was tested without extraction. Idylla™ results were compared with orthogonal NGS data for concordance, and turnaround times for routine FFPE-based testing were evaluated to model potential workflow improvements.Results: All four EGFR-mutated cases (p.L858R, p.G719A, and exon 19 deletions) were correctly detected by Idylla™, yielding 100% concordance with NGS. Among six KRAS-mutated cases, Idylla™ identified all p.G12C variants but missed p.G12V and p.Q61K, achieving 80% overall concordance. Median time from collection to NGS report was 22 days, whereas modeled same-day Idylla™ testing offered a theoretical reduction of approximately 20 days in turnaround time. Discordant cases correlated with relatively low tumor cellularity in cell blocks.Conclusions: Cytology supernatants preserved in CytoLyt® are a feasible substrate for rapid, cartridge-based molecular testing using the Idylla™ platform. This approach can serve as a complementary or rescue strategy when cellular slide preparations or FFPE tissue is limited or NGS fails, enabling faster access to actionable molecular results in NSCLC.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Current Status of Thyroid Cytology in the Era of New Classifications, Molecular Profiling, and Clinical Risk Stratification. 甲状腺细胞学在新分类、分子分析和临床风险分层时代的现状。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-30 DOI: 10.1159/000552287

Sule Canberk, Zubair W Baloch

{"title":"The Current Status of Thyroid Cytology in the Era of New Classifications, Molecular Profiling, and Clinical Risk Stratification.","authors":"Sule Canberk, Zubair W Baloch","doi":"10.1159/000552287","DOIUrl":"https://doi.org/10.1159/000552287","url":null,"abstract":"In recognition of the 70th anniversary of Acta Cytologica, this review delineates the historical and conceptual evolution of thyroid cytology from its origins in descriptive morphologic interpretation to its contemporary function within a structured, risk stratified, and multimodality informed diagnostic framework. Over successive decades, the major international reporting systems have progressively aligned around a shared hierarchical architecture; nonetheless, meaningful differences persist in the definition, operationalization, and clinical integration of indeterminate (\"grey zone\") diagnostic categories across regions and practice settings. Concurrently, refinements in histopathologic classification, particularly the formal recognition of borderline and other low risk neoplastic entities have recalibrated reported risks of malignancy without altering the foundational cytomorphologic features. These developments underscore the necessity for explicit outcome definitions and transparent denominator selection when estimating malignancy risk for individual diagnostic categories. Advances in contemporary molecular profiling, now feasible across routine cytology preparations, introduce an additional, sequential layer of risk modification. When interpreted in conjunction with ultrasonographic findings and clinical context, molecular data increasingly inform the management of indeterminate diagnoses and facilitate selection between active surveillance and surgical intervention. Moreover, the influence of ultrasound based sampling strategies and partial surgical verification on observed malignancy rates highlights the conditional and context dependent nature of category specific risk estimates, supporting the adoption of a Bayesian approach rather than reliance on fixed universal risk values. Taken together, these developments reaffirm the central role of thyroid cytology as a precise diagnostic modality and as an essential communication interface within contemporary, individualized thyroid nodule management.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TPS 2.0-based voided urine cytology from patients with pathologically-proven low-grade urothelial carcinoma: Comparison with TPS 1.0 and JRSUC 2015. 基于TPS 2.0的低级别尿路上皮癌患者空尿细胞学：与TPS 1.0和JRSUC 2015的比较

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-28 DOI: 10.1159/000552295

Toshihiko Kato, Yumiko Higuchi, Mei Oshima, Fuki Endo, Tomonari Toyama, Shiro Sugihara, Sotaro Kayano, Yasuo Imai

{"title":"TPS 2.0-based voided urine cytology from patients with pathologically-proven low-grade urothelial carcinoma: Comparison with TPS 1.0 and JRSUC 2015.","authors":"Toshihiko Kato, Yumiko Higuchi, Mei Oshima, Fuki Endo, Tomonari Toyama, Shiro Sugihara, Sotaro Kayano, Yasuo Imai","doi":"10.1159/000552295","DOIUrl":"https://doi.org/10.1159/000552295","url":null,"abstract":"Background: The Paris System (TPS) 1.0 for reporting urinary cytology focused on high-grade urothelial carcinoma (HGUC) but included low-grade urothelial neoplasm (LGUN) category by evaluating cell clusters. The 2015 Japan Reporting System for Urinary Cytology (JRSUC 2015) also includes low-grade urothelial carcinoma (LGUC) category. Then, TPS 2.0 deleted the LGUN category and completely focused on HGUC detection by evaluating only individual cells. We aimed to investigate this impact from the perspective of pathologically-proven LGUC diagnosis.Methods: Voided urine samples, suspected of new-onset bladder cancer, with corresponding pathological diagnosis within three months of cytological diagnosis were analyzed. TPS 2.0-based cytology was statistically compared with TPS 1.0- and JRSUC 2015-based ones.Results: 189 cases, consisting of 27 pathologically-proven benign lesions, 63 LGUC, 96 HGUC, and 3 other malignancies were analyzed. Cytological diagnosis demonstrated high correlation between TPS 2.0 and JRSUC 2015 (r = 0.96, p < 0.001) and complete coincidence between TPS 2.0 and TPS 1.0 (r = 1.00, p < 0.001). One and none of 63 pathological LGUC was classified as cytological LGUC/LGUN by JRSUC 2015 and TPS 1.0, respectively, validating restricted utility of the LGUC/LGUN category. Cytological diagnosis of pathological LGUC was almost identical among three reporting systems. These systems demonstrated similar concordance levels with pathological diagnosis (TPS 1.0 and 2.0: both r = 0.483, p < 0.001; JRSUC 2015: r = 0.484, p < 0.001).Conclusion: Even from the perspective of LGUC, TPS 2.0 would not be disadvantageous and is an excellent reporting system because of objectivity and simplicity.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Measurement of CYFRA 21-1 in Fine-Needle Washout of Cervical Lymph Nodes in Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis. CYFRA 21-1在分化型甲状腺癌颈部淋巴结细针冲洗中的测量：一项系统回顾和荟萃分析。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-28 DOI: 10.1159/000552244

Maria Luisa Garo, Massimo Bongiovanni, Armando De Virgilio, Luca Giovanella

{"title":"Measurement of CYFRA 21-1 in Fine-Needle Washout of Cervical Lymph Nodes in Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Maria Luisa Garo, Massimo Bongiovanni, Armando De Virgilio, Luca Giovanella","doi":"10.1159/000552244","DOIUrl":"https://doi.org/10.1159/000552244","url":null,"abstract":"Background Persistent or recurrent cervical lymph node metastases represent a frequent challenge during follow-up of differentiated thyroid carcinoma (DTC). Although fine-needle aspiration cytology (FNAC) and thyroglobulin measurement in FNA washout (FNA-Tg) are standard diagnostic tools, their performance may be limited in cystic or paucicellular lymph nodes and in patients with residual thyroid tissue or anti-thyroglobulin antibodies. Measurement of cytokeratin 19 fragment 21-1 (CYFRA 21-1) in FNA washout has been proposed as a complementary biomarker. Methods A systematic review and diagnostic test accuracy meta-analysis was conducted according to PRISMA-DTA guidelines and registered in PROSPERO. PubMed, Scopus, and Cochrane Central were searched through January 2026. Pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio were estimated using a bivariate random-effects model with hierarchical summary receiver operating characteristic analysis. Results Five studies comprising 533 patients and 681 lymph nodes were included. CYFRA 21-1 showed high pooled sensitivity (0.92, 95% CI 0.85-0.96) and specificity (0.97, 95% CI 0.89-0.99), with an area under the curve of 0.97. The diagnostic odds ratio was 173.1, and likelihood ratios suggested good rule-in and rule-out performance. Qualitative comparisons indicated that CYFRA 21-1 frequently show higher sensitivity than FNAC and comparable or higher specificity than FNA-Tg in selected challenging scenarios. Conclusions CYFRA 21-1 measurement in FNA washout shows promising diagnostic performance and may provide complementary information to cytology and thyroglobulin washout. However, the available evidence is limited and heterogeneous, and further prospective, multicenter studies with standardized protocols are required before routine clinical implementation can be recommended.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Qualitative System for Assessing Cytologic-Histologic Correlation in Non-Gynecologic Cytology Specimens. 评价非妇科细胞学标本细胞学-组织学相关性的定性系统。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-18 DOI: 10.1159/000552116

Fatima Zahra Aly, Donald Shumate, Safiya Nur Khambaty, Chenchu Nagarakanti

{"title":"Qualitative System for Assessing Cytologic-Histologic Correlation in Non-Gynecologic Cytology Specimens.","authors":"Fatima Zahra Aly, Donald Shumate, Safiya Nur Khambaty, Chenchu Nagarakanti","doi":"10.1159/000552116","DOIUrl":"https://doi.org/10.1159/000552116","url":null,"abstract":"Cytologic-histologic correlation (CHC) is a requirement by the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for laboratories that perform cytology-based gynecologic cancer screening. Gynecologic cytology has well-established criteria for performing CHC. To our knowledge, there is limited literature about the implementation of CHC protocols for non-gynecologic specimens such as fine-needle aspirations (FNA). Non-gynecologic cytology can provide useful information to clinicians by guiding next steps in management. CHC also provides a secondary utility for assessing staff competencies. The College of American Pathologists requires all laboratories to periodically assess competencies, and to perform proficiency testing to ensure diagnostic accuracy. We developed a system for real-time and/or retrospective CHC to recognize and grade any discordances that arise, and to review the causes of discrepancy. We describe an organ specific (pancreas) system of CHC with scoring of degree of discordance and benchmark setting of acceptable discrepancy for cytotechnologists and cytopathologists. Root cause analysis in discordant cases identifies the key issues that impact cytological diagnostic accuracy. This model can be utilized by any non-gynecologic cytology system to inform accuracy of diagnosis and effectively identify areas of improvement.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The long and winding road: the resilience of cervical cytology as a long-standing laboratory tool to aid the diagnosis of HPV-induced lesions. 漫长而曲折的道路：恢复宫颈细胞学作为一个长期的实验室工具，以帮助诊断hpv引起的病变。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-16 DOI: 10.1159/000552024

Adhemar Longatto-Filho

{"title":"The long and winding road: the resilience of cervical cytology as a long-standing laboratory tool to aid the diagnosis of HPV-induced lesions.","authors":"Adhemar Longatto-Filho","doi":"10.1159/000552024","DOIUrl":"https://doi.org/10.1159/000552024","url":null,"abstract":"Background: Despite molecular advancements, cervical cytology remains a resilient and fundamental laboratory tool in the prevention of cervical cancer.Summary: This article revisits the historical trajectory of knowledge about HPV, from the first descriptions of genital warts to the consolidation of the virus as a necessary etiological agent of cervical carcinogenesis. The central role of the Papanicolaou test in the early detection of precursor lesions is highlighted, as well as the importance of morphological recognition of koilocyte as a cytopathological marker of HPV infection. The inherent limitations of conventional cytology are discussed, including observer-dependent variability, and the strategies that have reinforced its diagnostic quality, such as liquid-based cytology, quality control, automation, artificial intelligence, and integration with molecular HPV tests. Key-message: Finally, the work emphasizes that the combination of cytology and molecular methods, including p16/Ki-67 tests and DNA methylation, reinforces the continued relevance of cytology as an essential and adaptable pillar of modern cervical cancer screening programs.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Real-world application of the WHO Reporting System for Lymph Node Cytopathology in the Context of the 5th Edition of the WHO Classification of Hematolymphoid Neoplasms. 世界卫生组织淋巴细胞病理学报告系统在世界卫生组织第五版淋巴细胞肿瘤分类中的实际应用。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-16 DOI: 10.1159/000551968

Ana G Yuil Valdes, Safina Hafeez, Terrance J Lynn, Joseph D Khoury

引用次数: 0

Recently identified diagnostic markers in effusion cytology. 最近确定的积液细胞学诊断标记。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-10 DOI: 10.1159/000551969

Ben Davidson

{"title":"Recently identified diagnostic markers in effusion cytology.","authors":"Ben Davidson","doi":"10.1159/000551969","DOIUrl":"https://doi.org/10.1159/000551969","url":null,"abstract":"Introduction: Effusion specimens are frequently encountered in cytopathology practice. As in surgical pathology, candidate markers for effusion diagnosis require thorough assessment prior to inclusion in diagnostic panels. This review discusses some of the currently used markers, with focus on immunohistochemistry.Methods: A literature search of relevant publications, with focus on markers with established diagnostic role.Results: BAP1 and MTAP protein expression by immunohistochemistry has been shown to be useful in the differentiation of reactive mesothelial proliferations from mesothelioma, as well as in differentiating the latter from metastatic carcinoma, in multiple studies. Molecular analysis analyzing CDK2NA, MTAP, BAP1 and NF2 status has been additionally applied to the differential diagnosis of mesothelioma from reactive mesothelium. Robust markers for the differentiation between mesothelioma and carcinoma, such as TAG-72/B72.3, claudin-4, calretinin and HEG1, are available, as are markers that support a specific origin for metastatic adenocarcinoma, such as PAX8, TTF1 and TRPS1.Conclusion: Effusion diagnosis remains central to staging, and consequently prognosis of cancer patients. Effusions additionally constitute optimal material for predictive studies and thereby guide the choice of targeted therapy. .","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Performance of The Paris System 2022 in Urinary Cytology: A Single-Institution Retrospective Study Comparing Voided and Instrumented Specimens. 巴黎系统2022在泌尿细胞学中的诊断性能：一项比较空白和仪器标本的单机构回顾性研究。

IF 1.7 4区医学

Acta Cytologica Pub Date : 2026-04-02 DOI: 10.1159/000551809

Pinar Uyar Göçün, Berkay Şimşek, Ece Öztürk, Betül Öğüt, İpek Işık Gönül

{"title":"Diagnostic Performance of The Paris System 2022 in Urinary Cytology: A Single-Institution Retrospective Study Comparing Voided and Instrumented Specimens.","authors":"Pinar Uyar Göçün, Berkay Şimşek, Ece Öztürk, Betül Öğüt, İpek Işık Gönül","doi":"10.1159/000551809","DOIUrl":"https://doi.org/10.1159/000551809","url":null,"abstract":"Background: Urinary cytology is a widely used, noninvasive tool for detecting high-grade urothelial carcinoma (HGUC). The Paris System for Reporting Urinary Cytology (TPS) was updated in 2022 (TPS 2.0) to improve diagnostic accuracy and reproducibility. This study evaluated TPS 2.0 performance and compared voided versus instrumented specimens using histopathological follow-up as the reference standard.Methods: We retrospectively reviewed 2,315 urinary cytology samples processed at Gazi University Faculty of Medicine in the years 2018 and 2019, identifying 371 cases with histopathological follow-up within six months. Cytology specimens were reclassified according to TPS 2022 categories and correlated with biopsy results. Risk of high-grade malignancy (RoHM), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated overall and stratified by specimen type (voided vs instrumented).Results: Of 371 cases, 93 (25.1%) were HGUC on histopathology. RoHM increased progressively across categories: NHGUC 4.4%, AUC 55%, SHGUC 72.7%, and HGUC 96%. Using HGUC alone as the positive category yielded high specificity (99.3%; 95% CI 97.4-99.8) but limited sensitivity (51.6%; 95% CI 41.6-61.5). Expanding thresholds to HGUC+SHGUC increased sensitivity to 68.8% (95% CI 58.8-77.3), while including AUC maximized sensitivity (80.6%; 95% CI 71.5-87.4) with reduced specificity (93.9%; 95% CI 90.4-96.1). Instrumented specimens outperformed voided urine, achieving higher sensitivity (88.7%; 95% CI 77.5-94.9) and specificity (94.3%; 95% CI 90.2-96.7).Conclusion: TPS 2022 provides reliable risk stratification for urinary cytology, with a predictable increase in RoHM across categories. Instrumented specimens demonstrate superior diagnostic performance, supporting TPS 2.0 as a robust framework for routine practice.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0