Acta Cytologica最新文献

{"title":"Intraoperative Rapid On-Site Evaluation of Lung Tumors: A Diagnostic Accuracy Study.","authors":"Konstantinos Christofidis, Alexandros Pergaris, Maria Kalfa, Eirini Klapsinou, Vasiliki Kyriakidou, Zoi Chodrodimou, Kyriaki Savvidou, Maria Terzi, Chrysa Stamou, Dimitrios Mallios, Kosmas Iliadis, Charitini Salla, Panagiota Mikou","doi":"10.1159/000543576","DOIUrl":"https://doi.org/10.1159/000543576","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer remains a major health challenge, and accurate diagnosis is crucial for effective treatment. Rapid on-site evaluation (ROSE) has emerged as a valuable tool in lung cancer diagnosis. This study aims to assess the performance of ROSE in the intraoperative diagnosis of lung cancer and its correlation with the histological findings of frozen sections.</p><p><strong>Methods: </strong>A retrospective review was conducted on 414 cases of intraoperative ROSE performed during lung surgeries between 2017 and 2022. Cytological findings were classified according to the World Health Organization Reporting System for Lung Cytopathology and compared with the subsequent histological diagnoses.</p><p><strong>Results: </strong>ROSE demonstrated a high diagnostic accuracy of 92.2%. The risk of malignancy varied across diagnostic categories, highlighting the value of ROSE in risk stratification. Only 12% of cases with a ROSE diagnosis of malignancy or suspicion of malignancy were discordant with the final histological diagnosis and only as to the specific tumor type.</p><p><strong>Conclusions: </strong>Rapid on-site evaluation is a reliable technique for lung cancer diagnosis, not only during EBUS or CT guided FNA but also in the setting of lung surgery, offering high accuracy and risk stratification. It contributes to improved patient management by optimizing procedures, reducing complications, and enhancing specimen quality for further analyses. ROSE is a valuable asset in the modern era of personalized medicine, facilitating tailored treatment approaches.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998277","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}

{"title":"p16INK4a / Ki67 dual staining immunocytochemistry to refer women infected by HR-HPV for colposcopy.","authors":"Magnus von Knebel Doeberitz","doi":"10.1159/000542504","DOIUrl":"https://doi.org/10.1159/000542504","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is still a significant global health issue, espacially in low- and middle-income countries. Human papillomavirus (HPV) infection is known to be the primary etiological factor in the development of cervical cancer. The identification of high-risk HPV infections in cervical screening is becoming crucial for early detection and management of cervical pre-neoplasia. However, HPV testing requires triage markers since HR HPV infections are widespread in the target population, of which only a small fraction requires detailed clinical work-up by colposcopy.</p><p><strong>Summary: </strong>p16INK4a is a tumor suppressor protein that has emerged as a promising surrogate marker for HPV infection. In combination with a proliferation marker Ki67 in one diagnostic test kit referred to as CINtecPlus®- or dual stain (DS) it revealed excellent sensitivity and specificity profiles to detect clinically relevant CIN2+ lesions among HPV-infected women in large screening cohorts.</p><p><strong>Key message: </strong>This review examines the role of the cytology CINtecPlus®-test (Dual Stain (DS)-test) as a triage marker to identify patients with CIN2+ lesions among HPV + tested women and summarizes the most recent recommendations for its clinical use.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998280","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}

{"title":"Critical evaluation of Pap test adherence to routine screening in Amazonas State, Brazil.","authors":"Rosana Lima de Oliveira, Emanuelle Cristina de Andrade Valente, João Guilherme de Souza Gadelha, Steven S Witkin, Juliana Yukari K Viscondi, Rita de Cássia Castro de Jesus, Lúcia Marques de Freitas, Ivanete de Lima Sampaio, Edson de Freitas Gomes, Kátia Luz Torres, Maria Cássia Mendes-Corrêa, Adhemar Longatto-Filho, Toni Ricardo Martins","doi":"10.1159/000543496","DOIUrl":"https://doi.org/10.1159/000543496","url":null,"abstract":"<p><strong>Introduction: </strong>This study critically evaluates adherence to Pap test screening practices in cytology-based cervical cancer screening in the state of Amazonas over a 10-year period.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted of the results of cytological screening examinations (Pap test) in Amazonas State from 2013 to 2023. For this purpose, Brazilian public databases Cervical Cancer Information System (SISCOLO) and Cancer Information System (SISCAN) (from The Department of Information and IT of the Unified Health System - DATASUS) were consulted.</p><p><strong>Results: </strong>There was a decrease in the number of Pap tests performed during the period from 2019 to 2021, likely related to the COVID-19 pandemic. This was followed by a subsequent increase in the post-pandemic period. Notably, in municipalities with fewer than 10,000 annual Pap examinations there was a decrease in the average number of tests when comparing the years 2016-2018 to 2013-2015, and an even greater decrease during the pandemic.</p><p><strong>Conclusions: </strong>There is considerable variation in utilization of the cytological Pap test across different municipalities. This lack of uniformity throughout the State likely compromises the capacity to detect early stage cervical intraepithelial lesions.</p><p><strong>Key words: </strong>Cervical cancer screening, cervical cytology, cytology in low-resource settings, Primary screening, Public health.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942441","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}

{"title":"Artificial Intelligence and Whole Slide Imaging Assist in Thyroid Indeterminate Cytology: A Systematic Review.","authors":"Olia Poursina, Azadeh Khayyat, Sara Maleki, Ali Amin","doi":"10.1159/000543344","DOIUrl":"https://doi.org/10.1159/000543344","url":null,"abstract":"<p><p>Thyroid cytopathology, particularly in cases of atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS), suffers from suboptimal sensitivity and specificity challenges. Recent advancements in digital pathology and artificial intelligence (AI) hold promise for enhancing diagnostic accuracy. This systematic review included studies from 2000 to 2023, focusing on diagnostic accuracy in AUS/FLUS cases using AI, whole slide imaging (WSI), or both. Of the 176 studies, 13 met the inclusion criteria. The datasets range from 145 to 964 WSIs, with an overall number of 494 AUS cases ranging from eight to 254. Five studies used convolutional neural networks (CNN), and two used artificial neural networks (ANN). The preparation methods included Romanowsky-stained smears either alone or combined with Papanicolaou-stained or H&amp;E, and Liquid-based cytology (ThinPrep). The scanner models that were used for scanning the slides varied, including Leica/Aperio, Alyuda Neurointelligence Cupertino, and PANNORAMIC™ Desk Scanner. Classifiers used include Feedforward Neural Networks (FFNN), Two-Layer Feedforward Neural Networks (2L-FFNN), Classifier Machine Learning Algorithm (MLA), Visual Geometry Group 11 (VGG11), Gradient Boosting Trees (GBT), Extra Trees Classifier (ETC), YOLOv4, EfficientNetV2-L, Back-Propagation on Multi-Layer Perceptron, and MobileNetV2. Although cytopathology is late in adopting AI, available studies have shown promising results in differentiating between thyroid lesions, including AUS/FLUS. Our review showed that AI can be especially effective in removing sources of errors such as subjective assessment, variation in staining, and algorithms. CNN has been successful in processing WSI data and identifying diagnostic features with minimal human supervision. ANNs excelled in integrating structured clinical data with image-derived features, particularly when paired with WSI, enhancing diagnostic accuracy for indeterminate thyroid lesions. A combined approach using both CNN and ANN can take advantage of their strengths. While AI and WSI integration shows promise in improving diagnostic accuracy and reducing uncertainty in indeterminate thyroid cytology, challenges such as the lack of standardization need to be addressed. This review highlights the heterogeneity in study designs, dataset sizes, and evaluation metrics. Future studies should focus on hybrid AI models, CNNs, ANNs, and standardized methodologies to maximize clinical applicability.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918885","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}

{"title":"Endoscopic ultrasound-guided fine needle aspiration of pancreatic neuroendocrine tumours with rapid on-site evaluation: single center experience.","authors":"Irem Guvendir Bakkaloglu, Begum Calim Gurbuz, Onur Sahin, Itir Ebru Zemheri","doi":"10.1159/000543364","DOIUrl":"https://doi.org/10.1159/000543364","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a highly sensitive and accurate method for identifying pancreatic neuroendocrine tumors (PanNETs). However, research on grading and assessing the Ki67 proliferation index in FNA samples is limited.</p><p><strong>Methods: </strong>This study analyzed 335 EUS-FNA cases performed between 2016 and 2022, of which 12 cases of PanNET were further evaluated. The morphology, Ki-67 index, and grading (G) of cell blocks (CB) obtained from the PanNET aspirations were compared to those of the resected material.</p><p><strong>Results: </strong>Out of 12 PanNET's with rapid on-site evaluation(ROSE), in FNA samples and CB,7 (58.3%) cases were G1,while 5 (41.7%) cases were G2.On the other hand,resection of these cases,6 (50%) were diagnosed as G1,5(41.7%) cases were G2,and 1 case(8.3%) was G3.The average ki67 index in CB was 2.92(min: 1-max: 10), while in resections it was 4.67(min: 1-max: 22).Only 2(16.6%) showed a discordance between grade and ki67, resulting in an overall concordance of over 80%.On average,1.83 needle passes were made(range: 1-3), while the average number of slides and cell blocks were 9.33(range: 1-24) and 2.17(range: 1-6),respectively.There were no significant differences in the number of passes,slides,or cell blocks between the consistent and discordant groups.</p><p><strong>Conclusion: </strong>Optimal counting techniques and sensitivity for Ki67 are crucial in grading PanNETs in both aspiration and resection materials.The grade and Ki67 index demonstrated high concordance when comparing CB and resection. However, in low-volume centers, ROSE support can be beneficial in obtaining sufficient slides and cell blocks for an adequate diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142918841","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}

{"title":"Image quantification analysis of cytoplasmic mucin and interpretation of mucin color in lobular endocervical glandular hyperplasia.","authors":"Fumikazu Kimura, Kengo Ohshima, Ryo Kanai, Takumi Urata, Takaki Kobayashi, Saori Takeyama, Masahiro Yamaguchi, Shiho Asaka, Keiko Ishii","doi":"10.1159/000543224","DOIUrl":"https://doi.org/10.1159/000543224","url":null,"abstract":"<p><strong>Introduction: </strong>Although the widespread use of screening tests and HPV vaccines for squamous cell carcinoma has led to early detection and treatment, effectiveness is limited for cervical adenocarcinoma. Lobular endocervical glandular hyperplasia (LEGH) corresponds to gastric metaplasia, but is regarded as a pathological condition with subtle morphological abnormalities. LEGH is a benign lesion and a precursor to gastric-type adenocarcinoma. We herein developed an objective and quantitative method by applying an image analysis technique to overcome the difficulties associated with the differential diagnosis of LEGH in uterine cervical cytology. This approach is expected to enable the early detection and accurate diagnosis of LEGH.</p><p><strong>Methods: </strong>We extracted signal values for the nucleus and cytoplasm from microscopic images of cytological specimens of normal endocervical (EC) and LEGH cells. These values were then converted into CIELAB and sRGB values to create color distribution maps, and color unmixing techniques were applied to assess the spectral absorbance of each pigment.</p><p><strong>Results: </strong>The CIELAB signal values extracted from the nuclear images of LEGH cells exhibited lower values than those of EC cells. Furthermore, based on color distribution maps, the cytoplasm of EC cells exhibited shades from purple to pink, while LEGH cells showed a distribution towards yellow.</p><p><strong>Conclusions: </strong>This study reveals that, compared to EC cells, LEGH cells exhibit lower nuclear signal values and increased nuclear chromatin content. Thus, assessing the relative difference in cytoplasmic color tones between them may become an effective indicator for distinguishing between EC and LEGH cells.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-26"},"PeriodicalIF":1.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891232","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}

{"title":"Diagnostic and Predictive immunocytochemistry in Head Neck lesions.","authors":"Pietro Tralongo, Federica Policardo, Federica Vegni, Angela Feraco, Belen Padial Urtueta, Qianqian Zhang, Giulia Ferraro, Elena Navarra, Angela Santoro, Antonino Mule, Esther Diana Rossi","doi":"10.1159/000543210","DOIUrl":"https://doi.org/10.1159/000543210","url":null,"abstract":"<p><strong>Background: </strong>The application of immunocytochemistry (ICC), as a diagnostic and predictive tool in the workup of head and neck lesions has followed the changes and progresses in the surgical pathology evaluation. The contribution of ICC has shown a significant role in the head and neck cytology, demonstrating as its contribution can support the diagnosis in many lesions. Furthermore, its role has been evolving as an important asjuvant tool in targeted therapies. An additional useful role is defined by the recent introduction of ICC-markers related to genetic alterations, which has opened the door to the adoption of a surrogate of molecular evaluation also on cytological material. SUMMARY The current review article analyzes the role of ICC in the field of head and neck cytology, showing that it might represent a valid diagnostic tool in difficult cases. The review will include all the different head and neck lesions, demonstrating how we could rely on organ-specific ICC markers but also on ICC markers able to discriminate between benign and malignant lesions.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-40"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880914","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}

{"title":"Insights into thyroid and salivary gland cytopathology: highlights from a 45th ECC slide seminar.","authors":"Camille Brochard, Adam Kowalewski, Elena Vigliar, Rita Luis, Ozlem Aydin, Jerzy Klijanienko, Sule Canberk","doi":"10.1159/000543225","DOIUrl":"https://doi.org/10.1159/000543225","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid and salivary gland cytopathology frequently present diagnostic challenges due to complex presentations, overlapping features between benign and malignant conditions, particularly with grey-zone entities and rare pathologies. To address these issues, the 45th European Congress of Cytology (ECC) held a slide seminar focused on challenging cases. This article reviews key findings from the six cases discussed, emphasizing the importance of a comprehensive diagnostic approach. The objective of this article is to illustrate the diagnostic challenges of rare thyroid and salivary gland lesions through case presentations, showing the need for a comprehensive, multidisciplinary approach to accurately reach a final diagnosis and steer the patient's management.</p><p><strong>Case presentation: </strong>The seminar presented cases involving fine-needle aspiration cytology (FNAC) followed by histopathological correlation, molecular and cytogenetic analyses or immunohistochemistry (IHC) markers to elucidate cytomorphological features, differential diagnoses, and final diagnoses of rare cases in thyroid and salivary gland cytopathology. Challenging thyroid cytology cases included differentiating thyroid sarcoidosis from malignancy, identifying intrathyroidal ectopic thymus versus lymphoid neoplasms, and recognizing poorly differentiated thyroid carcinoma initially misinterpreted as a benign follicular neoplasm. Complex salivary gland cases addressed the distinction of basal cell adenocarcinoma from adenoid cystic carcinoma, metastatic SMARCB1-deficient carcinoma diagnosed via immunohistochemistry and a parotid mass initially identified as a Warthin tumor.</p><p><strong>Conclusion: </strong>These cases highlight the critical role of integrating cytological, clinical and histopathological data to navigate the diagnostic complexities of thyroid and salivary gland lesions. A multidisciplinary approach and standardized algorithms are essential for improving diagnostic accuracy and patient outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862783","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}

{"title":"Role of Immunocytochemistry in the Cytological Diagnosis of Mesothelioma.","authors":"Claire W Michael, Shannon Alexandra Rodgers","doi":"10.1159/000543048","DOIUrl":"10.1159/000543048","url":null,"abstract":"<p><strong>Background: </strong>Mesothelioma is an aggressive malignancy of the serosal surfaces with very poor prognosis. It traditionally manifests in older patients and at an advanced stage which results in minimal improvement in prognosis despite the recent advances in management. Early detection would therefore significantly impact management and potentially improve survival. Mesothelioma frequently presents with recurrent effusions, posing cytology as the initial procedure in the workup. A definitive diagnosis would not only spare the patients additional diagnostic procedures but also potentially afford them an opportunity for early surgical intervention and therapy.</p><p><strong>Summary: </strong>In this article, we review the role of immunocytochemistry (ICC) in the workup of mesothelioma. The various ICC markers to confirm or rule out mesothelial lineage are reviewed. In addition, newly introduced molecular surrogates that confirm the malignant nature of the mesothelial cells and support a definitive diagnosis of mesothelioma are discussed. We also briefly discuss the theranostic implications of such markers and potential impact of such recent advances on the cytological diagnosis and reporting of mesothelioma.</p><p><strong>Key messages: </strong>The cytological diagnosis of mesothelioma no longer requires the extensive expertise in morphological analysis and can be offered based on supporting ICC that confirms the mesothelial lineage and malignant nature of the cells.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-18"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816990","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}

{"title":"Applicability of the International Cytopathology Reporting System of Serous Fluids in a Brazilian City.","authors":"Caio Rodrigo Dos Santos, Daniel José da Silva, Deolino Joao Camilo Junior, José Cândido Xavier-Junior","doi":"10.1159/000543045","DOIUrl":"https://doi.org/10.1159/000543045","url":null,"abstract":"<p><strong>Introduction: </strong>The International Academy of Cytology and the American Society of Cytopathology developed the International System of Serous Fluid Cytopathology (TIS) to standardize cytological reports. Effusions in pleural, peritoneal, and pericardial cavities are valuable sources of information for medical diagnosis, especially in oncological scenarios. The TIS classification is divided into five categories: non-diagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspected malignancy (SFM), and malignant (MAL). It facilitates global communication between specialists, aiming for future clinical management guidelines based on malignancy risk assessment.</p><p><strong>Methods: </strong>This quantitative analytical and retrospective study evaluated serous fluids (pleural, pericardial, and peritoneal) sent to the Instituto de Patologia de Araçatuba (IPAT), São Paulo, Brazil, from public and private hospitals between January 2017 and December 2022. Epidemiological and clinical data were collected from institutional files, including biopsies and immunohistochemical results.</p><p><strong>Results: </strong>The study included 719 patients with 763 serous fluid samples (pericardial, pleural, and peritoneal) analyzed over six years. The majority of samples were from pleural effusions (n = 438; 57.4%), followed by peritoneal (n = 293; 38.4%) and pericardial effusions (n = 32; 4.2%). Samples were classified using the International Serous Fluid Cytopathology System (TIS), revealing the following distribution: ND (0.41%), NFM (70.30%), AUS (0.95%), SFM (11.90%), and MAL (16.44%). The risk of malignancy calculated for each category were ND 66.67%, NFM 23.39%, AUS 28.57%, SFM 48.28%, and MAL 84.17%.</p><p><strong>Conclusion: </strong>The ROM was out of the interval proposed by the TIS in all categories. These findings suggest the applicability of TIS even outside of the cancer center environment, although the presented ROM frequencies were out of the recommended range.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799059","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}