Acta Cytologica最新文献

{"title":"Clinical decision-making and risk of malignancy when parotid gland fine needle aspiration cytology indicates a non-neoplastic or non-diagnostic finding.","authors":"Mira Naukkarinen, Katri Aro, Jetta Kelppe, Minna Sirviö, Antti Mäkitie, Jussi Tarkkanen, Timo Atula","doi":"10.1159/000545145","DOIUrl":"https://doi.org/10.1159/000545145","url":null,"abstract":"<p><strong>Introduction: </strong>Non-neoplastic and non-diagnostic cytological findings present a diagnostic and therapeutic challenge in Head and Neck oncology. Both groups still harbor a risk of malignancy (ROM). Of note, ROM values have been counted from surgically confirmed lesions only. The purpose of this study was to evaluate the clinical course of patients with non-neoplastic or non-diagnostic fine needle aspiration cytology (FNAC) findings from a parotid gland lesion.</p><p><strong>Methods: </strong>This retrospective cohort study comprises all 184 consecutive patients who visited the Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital (HUS, Helsinki, Finland) and whose first parotid gland FNAC result during 2016-2018 was non-neoplastic or non-diagnostic. The cytology reports were obtained from the HUS Pathological Archives (Q-Pati). Demographics, physical examination findings, and cytopathological and treatment data were reviewed. Two patient groups were formed according to their clinical management: those who had surgery and those who were only followed up. If the parotid gland was operated on, FNAC was compared with histology. If the patient was followed up without surgical treatment, the follow-up data included a review of the patient records supplemented with a questionnaire.</p><p><strong>Results: </strong>Altogether, there were 186 parotid lesions. Seventy-six (40.9%) tumors in 75 patients were operated on, and 110 (59.1%) were only followed up. Of all parotid gland lesions, 12 (6.5%) turned out to be malignant, and all of them were in the surgically treated group. When only followed up clinically, with repeated needle sampling or imaging during the minimum four-year follow-up period, none of the other lesions turned out to be malignant.</p><p><strong>Conclusion: </strong>The risk of malignancy for non-diagnostic and non-neoplastic FNAC samples is lower when all FNAC samples, including also those from non-surgically treated patients, are included in comparison with the series that includes only surgically treated patients with histopathological confirmation. Our results suggest that this patient group can be followed up conservatively in the absence of abnormal symptoms or radiological findings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-21"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794353","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":"Oncocytic Adrenal Tumors: A Tri-Focal Review with Integrated Cytopathological, Pathological, and Molecular Perspectives.","authors":"Vincenzo Condello, Massimo Bongiovanni, C Christofer Juhlin","doi":"10.1159/000545715","DOIUrl":"https://doi.org/10.1159/000545715","url":null,"abstract":"<p><strong>Background: </strong>Oncocytic lesions of the adrenal gland pose several diagnostic challenges, as they can be associated with both functional and non-functional adrenal disorders and may be either benign or malignant.</p><p><strong>Summary: </strong>Oncocytic tumors are predominantly (>90%) composed of oncocytic cells, characterized by bulky, eosinophilic cytoplasm due to an abundance of mitochondria. Notably, the conventional histopathological criteria for diagnosing adrenal cortical carcinoma (ACC), such as the Weiss criteria, are not recommended for oncocytic tumors, and separate classification algorithms have been proposed for this entity. In addition to their unique cytopathology and histopathology, oncocytic adrenal cortical neoplasms share many driver gene alterations with conventional adrenal tumors, albeit at lower frequencies. However, these tumors also exhibit some distinct genetic changes, particularly deletions of mitochondrial DNA, which is consistent with patterns seen in oncocytic lesions of other endocrine organs. Interestingly, the presence of oncocytic features may correlate with prognosis in ACCs, making this morphological distinction clinically significant. Some studies suggest that oncocytic features could be linked to either a more favorable or unfavorable outcome, depending on other molecular markers. This highlights the importance of accurate diagnostic work-up for these lesions and underscores the critical role of endocrine pathologists in their management. While cytology is not part of the routine work-up for primary adrenal tumors, fine-needle aspiration cytology may still be useful in distinguishing primary adrenal tumors from metastases.</p><p><strong>Key messages: </strong>This review examines the histological and molecular characteristics of oncocytic adrenal cortical lesions, highlighting their clinically relevant differences from conventional adrenal tumors. It clarifies the limited role of cytology in diagnosing primary adrenal tumors while recognizing its usefulness in distinguishing adrenal metastases. Finally, it underscores the need for a tailored diagnostic approach to effectively manage this complex entity. .</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794360","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":"Oncocytic Tumors in the Familial and Syndromic Contexts: A Tri-Focal Review - Integrated Cytopathological, Pathological, and Molecular Perspectives.","authors":"Maria Cristina Riascos, Vania Nosé","doi":"10.1159/000545321","DOIUrl":"https://doi.org/10.1159/000545321","url":null,"abstract":"<p><strong>Background: </strong>Familial neoplastic syndromes are distinguished by the presence of specific neoplasms which serve as critical indicators for their suspicion and diagnosis. Among these, only a limited subset includes tumors with distinctive oncocytic features, highlights the necessity for pathologists and clinicians to pursue further investigation in affected patients and their families.</p><p><strong>Summary: </strong>Advances in genetic research and diagnostic pathology have highlighted the germline predispositions underlying these tumors, which manifest across multiple organ systems, including thyroid, parathyroid, renal, and adrenal glands. This review examines the clinical, pathological, and molecular features of oncocytic neoplasms in the context of hereditary syndromes such as Carney Complex, Li-Fraumeni Syndrome, DICER1 Syndrome, Birt-Hogg-Dubé Syndrome, Hyperparathyroidism-Jaw Tumor Syndrome, Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome, Tuberous Sclerosis Syndrome, Beckwith-Wiedermann Syndrome and SDH-Deficient Hereditary Paraganglioma/ Pheochromocytoma Syndrome. It emphasizes the importance of recognizing syndromic associations through histopathological clues, genetic testing, and family history to facilitate accurate diagnosis and tailored management.</p><p><strong>Key message: </strong>By integrating clinical insights with molecular data, this paper sheds light on the mechanisms driving oncocytic transformation and underscores the role of pathologists in identifying hereditary cancer syndromes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-27"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778662","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":"Improving diagnostic accuracy of indeterminate thyroid fine needle aspiration using results of ultrasound examination, cyclin D1 immunostaining and molecular testing.","authors":"Shurong He, Jingxin Zhang, Mengge Wang, Feiliang Wang, Kan Gao, Rongming Chen, Songtao Hu, Jing Di, Dongge Liu, Mulan Jin","doi":"10.1159/000545319","DOIUrl":"https://doi.org/10.1159/000545319","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Fine-needle aspiration (FNA) is the standard procedure for diagnosing thyroid nodules, however indeterminate cytological results present considerable challenges in clinical management. This study aimed to evaluate cyclin D1 immunocytochemistry and Chinese thyroid imaging reporting and data system (C-TIRADS) score, individually and in combination with a simple gene test for cytological diagnosis of Bethesda category Ⅲ‑Ⅴ.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A consecutive cohort of 177 thyroid FNA specimens with indeterminate diagnoses and available histopathologic follow‑up data were collected. The samples were evaluated by cyclin D1 immunocytochemistry and molecular testing for the BRAFV600E mutation or for a small panel of markers (BRAF, N‑RAS, H‑RAS, K‑RAS and TERT). Two experienced sonographers independently reviewed original sonographic images of each nodule and classified them using the C-TIRADS to reach a consensus score. We evaluated the optimal cut‑off points for cyclin D1 and C-TIRADS scores in diagnosing malignancy using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). The specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of all tests were evaluated with the crosstabs. Logistic regression analysis and ROC curve analysis were used to evaluate the diagnostic accuracy of the three tests individually and combination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We enrolled 169 patients (177 thyroid nodules), including 140 malignances, 15 low-risk neoplasms, and 22 benign lesions. All 177 specimens were tested for BRAF V600E, while only 21 specimens used the 5-gene detection protocol. With cut-off values set at 10% for cyclin D1 immunocytochemistry and at a C-TIRADS score of 3, along with defining a positive diagnosis as the presence of a mutation in genetic testing, the PPVs for diagnosing thyroid malignancy using the three tests were 97.8%, 90.3%, and 98% respectively; however, the NPVs were 50%, 24.2%, and 26.3 %. The sensitivities were 87.7%, 83.9%, and 63.9%, and the specificities were 86.4%, 36.4% and 90.9%. Regarding AUC, cyclin D1 alone demonstrated greater diagnostic accuracy (0.921, 95%CI=0.857-0.985, P=0.000) compared with the other two methods, which had AUC values of 0.775 (95%CI=0.703-0.846, P=0.000) and 0.587 (95%CI=0.443-0.731, P=0.235). The combination of two or three tests yielded higher accuracy (0.929, 95%CI=0.873-0.985, P=0.000; 0.925, 95%CI=0.860-0.989, P=0.000; 0.937, 95%CI=0.889-0.985, P=0.000) compared with cyclin D1 immunocytochemistry alone (0.921, 95%CI=0.857-0.985, P=0.000).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Adding cyclin D1 immunocytochemistry or a simple gene panel test, alone or in combination, significantly enhances the diagnostic value of the C-TIRADS score in thyroid nodules with indeterminate cytology. Laboratories should integrate these tests to effectively manage uncertain thyroid nodules and reduce diagnos","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-23"},"PeriodicalIF":1.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778661","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":"Oncocytic Tumors in the Salivary Gland: Cytopathological, Pathological, and Molecular Features.","authors":"Alena Skálová, Martina Bradová, Arnaud Da Cruz Paula, William C Faquin","doi":"10.1159/000544802","DOIUrl":"https://doi.org/10.1159/000544802","url":null,"abstract":"<p><p>Primary oncocytic salivary gland tumors and oncocytic subtypes of traditionally non-oncocytic salivary gland neoplasms are occasionally encountered in fine needle aspiration (FNA) specimens, biopsies, and resections. Oncocytes are cells, either non-neoplastic or neoplastic, containing increased numbers of mitochondria resulting in cells with abundant eosinophilic cytoplasm and a low N/C ratio. A broad range of salivary gland tumors can be oncocytic including oncocytoma, Warthin tumor, mucoepidermoid carcinoma, salivary duct carcinoma, and others. Especially those tumors where the oncocytic pattern represents a subtype of neoplasm, the oncocytic pattern can create a diagnostic challenge due to marked similarities in the oncocytic pattern of cells. While their microscopic cytologic and histologic features may be similar, these tumors differ instrinscially at the molecular level. Ancillary studies such as immunologic and (e.g. androgen receptor for salivary duct carcinoma) molecular analysis, e.g. FISH for detecting the MAML2 or PLAG1/HMGA2 gene alterations in mucoepidermoid carcinoma and pleomorphic adenoma, respectively, can be used to classify these oncocytic tumors in difficult cases.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762680","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":"Digital pathology in real-life conditions for daily cytopathological diagnosis: a feasibility study.","authors":"Ranya Soufan, Alicia Larive, Irène Villa, Anne Auperin, Jean-Yves Scoazec, Voichita Suciu","doi":"10.1159/000545391","DOIUrl":"https://doi.org/10.1159/000545391","url":null,"abstract":"<p><strong>Background: </strong>Nowadays, there is an increasing adoption of digital pathology for diagnostic purposes.</p><p><strong>Aim: </strong>Herein we study the feasibility of cytopathological diagnosis by whole slide imaging (WSI) in daily practice.</p><p><strong>Material and methods: </strong>Hundred and ten consecutive non-gynecologic cytopathology cases, originally diagnosed under light microscopy (LM) by two pathologists, were scanned at X40. Then, cases were diagnosed on WSI, by the same pathologist who originally rendered the conventional diagnosis. The pathologists were blinded to the diagnosis made by light microscopy, but they had access to the same clinical information. The washout period was at least 3 months. WSI diagnoses were compared to the original LM diagnoses, and cases were considered concordant if the two types of diagnosis were identical.</p><p><strong>Results and analysis: </strong>LM and the WSI diagnoses were concordant in 87.3% [95%CI: 79.6; 92.9] of cases. Intra-observer agreement was lowest for thyroid fine-needle aspiration cytology (FNAC) (only 1 case out of 5). After exclusion of thyroid cases, the concordance rate between WSI and LM was 90.5% [95%CI: 83.2%; 95.3%].</p><p><strong>Conclusion: </strong>Primary cytological diagnosis can be done using our digital system.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-16"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750536","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":"Comparative Diagnostic Utility of Squash, Scrape and Imprint cytology in Intraoperative Diagnosis of Ovarian Tumours.","authors":"Gajendra Kumar Yadav, Ravi H Phulware, Ashok Singh, Arvind Kumar, Prashant Durgapal, Nilotpal Chowdhury, Shalinee Rao, Shalini Rajaram, Sanjeev Kishore, Rajlaxmi Mundhara","doi":"10.1159/000545110","DOIUrl":"https://doi.org/10.1159/000545110","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative cytology in ovarian tumors involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins and identification of lymph nodes metastasis.</p><p><strong>Aim: </strong>To evaluate comparative diagnostic utility of squash smear, scrape smear and imprint cytology with frozen section in intraoperative ovarian tumour.</p><p><strong>Materials and methods: </strong>Intraoperative tissue from clinico-radiologically suspected ovarian. tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear and imprint smear were made. Three stains (Rapid MGG, Rapid Pap and Rapid H &amp; E) with expected TAT of <15 minutes were done. Intraoperative cytological smear (squash, scrape and imprint smear) were correlated with frozen section &amp; Histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study.</p><p><strong>Results: </strong>Sensitivity, Specificity, and Diagnostic accuracy for frozen and cytology were: Sensitivity of frozen section, squash cytology and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology and scrape cytology was 96.77%, 93.55%, 90.32% and 90.32% respectively and accuracy was 94.55%, 90.91%, 90.91% and 90.91% respectively.</p><p><strong>Conclusion: </strong>Imprint, squash, and scrape cytology has similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699304","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":"Assessment of Nucleic Acid Quality in Unstained Cytology Specimens for Cancer Genomic Testing.","authors":"Hiroya Niimi, Takafumi Onishi, Shoma Nomura, Aya Kumazaki, Yuto Masaki, Hirokazu Odashima, Yukihiko Osawa, Manabu Hattori","doi":"10.1159/000545423","DOIUrl":"https://doi.org/10.1159/000545423","url":null,"abstract":"<p><strong>Introduction: </strong>The use of cytological specimens in cancer genome medicine has garnered considerable attention, but the long-term quality of nucleic acids from unstained specimens remains unclear. This study aimed to evaluate the quality of nucleic acids extracted from unstained specimens fixed with 95% ethanol or spray fixation over varying durations.</p><p><strong>Methods: </strong>Two lung cancer cell lines were prepared using the auto smear method and fixed with 95% ethanol, and spray-fixed specimens were stored for 30 min, 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months, and 6 months. DNA was extracted using a DNA extraction kit, and quality was assessed using agarose gel electrophoresis and PCR.</p><p><strong>Results: </strong>Nucleic acids extracted from unstained specimens showed no fragmentation after six months of fixation and were amplifiable by PCR, regardless of the fixation method.</p><p><strong>Conclusion: </strong>Nucleic acids extracted from unstained specimens preserved high quality over six months, suggesting that such specimens are suitable for genetic testing. This finding has significant implications for the long-term storage and clinical application of cytological specimens in cancer genome medicine.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699302","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":"Warthin's tumour diagnostic outcome in the Milan System era and cytomorphological pitfalls.","authors":"Henri Lagerstam, David Kalfert, Ivana Kholová","doi":"10.1159/000544973","DOIUrl":"https://doi.org/10.1159/000544973","url":null,"abstract":"<p><strong>Background: </strong>Warthin´s tumor (WT) is the second most common salivary gland neoplasm. With classic cytomorphological features of WT, the diagnostic accuracy is over 95%. WT is usually categorized as benign neoplasm according to the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).</p><p><strong>Methods: </strong>Database search at the Department of Pathology, Fimlab Laboratories, Tampere, Finland revealed 146 WTs during a 10-year period (January 1st, 2013-December 31st, 2022). Diagnostic accuracy was calculated for the entire study period, and the study period divided in half to pre-MSRSGC years (2013-2017) and MSRSGC years (2018-2022). In addition, a separate cytomorphology analysis of false-negative cases that were classified according to the MSRSGC, was performed.</p><p><strong>Results: </strong>Diagnostic accuracy was 96.4%, sensitivity was 68.5%, and specificity was 99.8%. Sensitivities and specificities were almost equal during the pre-MSRSGC years and the MSRSGC years. The number of true-positive cases was 113. Fifty-five cases (52 false-negative and three false-positive cases) were not accurately diagnosed. Risk of malignancy and risk of neoplasm were 0.0% and 98.3% of cases that were cytologically diagnosed as WT. Cytomorphological analysis showed that lack of papillae, the presence of small groups, and cystic degeneration led to false diagnoses. In addition, necrosis and diffuse hypercellularity increased the suspicion of malignancy and led to classification of fine-needle aspirations as salivary gland neoplasm of uncertain malignant potential.</p><p><strong>Conclusion: </strong>The MSRSGC is useful in WT diagnostics, and it improves communication between cytopathologists and clinicians. In this study, the most useful cytomorphological features that led to accurate WT diagnoses was papillary architecture in cell block specimens and the most significant pitfall was necrosis followed by diffuse hypercellularity.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699308","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":"Human Papillomavirus Primary Screening and Collaboration in Quality Assurance Work between Laboratories.","authors":"Henrik Edvardsson, Joakim Dillner","doi":"10.1159/000544988","DOIUrl":"10.1159/000544988","url":null,"abstract":"<p><strong>Background: </strong>Cervical screening is changing to the use of human papillomavirus (HPV) testing as the primary screening test. It is essential that the well-established and critically important systems for quality assurance based on laboratory audits of seemingly negative samples taken before HSIL and cervical cancer are maintained. They provide a means of verifying if the actual screening is effective for the intended purpose. Together with international proficiency panels, audits provide a simple and unambiguous way to evaluate if the screening is adequate. Detailed knowledge of how these systems work and how they are dependent on the genotyping of HPV, biobanking, and screening registries is vital to cytologists and pathologists involved in quality assurance work and follow-up of cervical lesions and cervical cancer. Interpretation and communication of outcome and results are equally important for successful quality assurance work and should ideally be done together with expertise in HPV.</p><p><strong>Summary: </strong>The internationally defined procedures for laboratory audit, similar to those used for cytology, require sensitivities before HSIL of >95% and before invasive cervical cancer of >90%. If also results on blinded proficiency panels and international criteria for analytic sensitivity, specificity, and reproducibility are achieved, the HPV screening test can be said to be adequate.</p><p><strong>Key messages: </strong>Performance of HPV screening tests in a cervical screening program includes similar laboratory audits as hitherto used for cytology. Similarly, technical proficiency of a laboratory is established using blinded proficiency panels with defined contents of virus. Detailed knowledge of quality assurance work is necessary for cytologists and pathologists. Communication of outcome and results depends on collaboration between laboratories.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603140","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}