Acta Cytologica最新文献

{"title":"Analysis of Cytomorphologic Alterations Noted in Pap Test Smears in Women with Infertility: An Institutional Experience.","authors":"Sujaya Mazumder, Indranil Chakrabarti, Saiqa Nisar, Harishankar G, Rama Saha, Sayanti Paul","doi":"10.1159/000552499","DOIUrl":"10.1159/000552499","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility is a growing global health concern, affecting 60-80 million couples worldwide, of which 15-20 million are in India. Cervical health plays a pivotal role in reproduction, acting as both a barrier to infection and a facilitator of fertilization. Pap smear test (PST), though traditionally used for cervical cancer screening, may provide valuable insights into cervical pathology, infections, and microenvironmental changes associated with infertility. The aim and objectives of the present study are to evaluate cytomorphological alterations in PST in women with infertility and assess their role in identifying reversible causes affecting fertility.</p><p><strong>Materials and methods: </strong>An ambispective study was conducted in the Department of Pathology and Laboratory Medicine at AIIMS Kalyani over 3 years (July 2022-June 2025). Women with primary or secondary infertility were included. PSTs were prepared using both conventional and liquid-based cytology, stained as per standard protocols, and reported using the Bethesda System for reporting cervical cytology (2014). Clinical and demographic data were recorded, and statistical analysis was applied to evaluate findings.</p><p><strong>Results: </strong>A total of 241 infertile women underwent PST. Of these, 204 (84.6%) had primary infertility and 37 (15.3%) had secondary infertility. Inflammation was detected in 234 cases (97.1%), ranging from mild (58.8%) to severe (9.1%). Significant PST changes were observed in 153 (63.5%) cases, including moderate to severe inflammation, infections, and epithelial abnormalities. Infectious etiologies included bacterial vaginosis (24.5%), candidiasis (5.4%), and trichomoniasis (0.8%). Lactobacilli depletion was noted in 28% of cases. Epithelial abnormalities were rare, with one case of low-grade squamous intraepithelial lesion and one case of atypical squamous cells of undetermined significance.</p><p><strong>Conclusion: </strong>PST, being simple, cost-effective, and widely accessible, is a valuable tool for identifying reversible causes of infertility, such as infections, inflammation, and altered microbiota. Incorporating PST into routine infertility workup may facilitate timely diagnosis and management, ultimately improving reproductive outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959386","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":"Meta-Analytic Estimates of Risk of Malignancy of Cytopathology Reporting Systems: Lacunae, Limitations, and a Proposed Solution with an Example from the International Academy of Cytology Yokohama System for Breast Cytopathology.","authors":"Kranthi Kumar Jandrasupalli, Monika Singh, Neha Singh, Sridevi Rajaganesh, Nilotpal Chowdhury","doi":"10.1159/000552516","DOIUrl":"10.1159/000552516","url":null,"abstract":"<p><strong>Introduction: </strong>Cytopathology reporting systems classify fine-needle aspiration biopsy (FNAB) specimens into ordered diagnostic categories; each associated with a category-specific risk of malignancy (ROM). ROM is widely used to guide clinical management; however, it is a posttest probability that depends on disease prevalence and category-specific likelihood ratios. Despite this, most meta-analyses report pooled ROM values without explicitly defining the underlying pretest probability, resulting in statistically uninterpretable and clinically misleading estimates.</p><p><strong>Methods: </strong>We reanalyzed data from a previously published meta-analysis of 22 studies evaluating the International Academy of Cytology (IAC) Yokohama System for reporting breast FNAB. A Bayesian multinomial mixed effects model was applied to estimate category-specific likelihood ratios. These were used to calculate posttest probabilities (ROM) across a wide range of pretest probabilities (5-95%), rather than reporting a single pooled ROM. The inadequate category was excluded from the primary analysis and included in sensitivity analyses. Model performance was assessed using a principled Bayesian workflow, including convergence diagnostics and posterior predictive checks.</p><p><strong>Results: </strong>The model demonstrated good convergence and fit. Category-specific likelihood ratios showed a clear and ordered gradient across diagnostic categories. ROM varied substantially with changes in pretest probability, particularly for intermediate categories, highlighting the limitations of fixed ROM estimates. Sensitivity and specificity estimates at different diagnostic cut-offs were comparable to those of the original meta-analysis.</p><p><strong>Conclusion: </strong>ROM is not an intrinsic property of cytopathology categories but a context-dependent posttest probability. Meta-analyses should report category-specific likelihood ratios or ROM across defined pretest probabilities to ensure statistical validity and clinical usefulness. The proposed approach provides a robust framework for interpreting multicategory cytopathology systems and should be adopted in future diagnostic accuracy studies.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959409","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":"Liquid-Based Cytology in Cervical Cancer Screening: A Systematic Review and Meta-Analysis.","authors":"Gerd Böhmer, Claudia Stolte, Tobias Vogelmann, Tino Schubert","doi":"10.1159/000551747","DOIUrl":"10.1159/000551747","url":null,"abstract":"<p><strong>Introduction: </strong>While the conventional Papanicolaou (Pap) smear has long been the cornerstone of cervical cancer (CC) screening, it presents well-documented limitations in sample collection, processing, and interpretation. Liquid-based cytology (LBC) was introduced to address these drawbacks by offering more uniform cell samples and enabling standardized evaluation. However, due to ongoing debate and conflicting study results regarding their comparative diagnostic accuracy, a rigorous evidence-based assessment is needed. The objective of this systematic review and meta-analysis was to systematically assess the diagnostic accuracy of LBC compared to conventional Pap cytology in the detection of cervical precancerous and cancerous lesions.</p><p><strong>Methods: </strong>PubMed and Cochrane Library were systematically searched. Comparative studies of LBC and conventional Pap cytology in primary CC screening were included. Outcomes included unsatisfactory sample rate, abnormal histology-confirmed cytology detection rate (ADR) CIN2+ lesions (cervical intraepithelial neoplasia), squamous cell carcinoma (SCC), and glandular abnormalities. Random-effects models were used to estimate risk ratios (RRs). A two-sided p value of 0.05 was used to determine statistical significance.</p><p><strong>Results: </strong>Ninety-seven studies were included. LBC had a lower unsatisfactory sample rate than conventional Pap cytology (RR: 0.63, 95% CI: 0.47-0.85, p = 0.003). The detection rate of SCC was similar (RR: 1.77, 95% CI: 0.96-3.26, p = 0.07). The glandular abnormality detection rate showed no overall difference (RR: 1.23, 95% CI: 0.75-2.02, p = 0.42), but a subgroup analysis (FDA-approved tests) showed superiority of LBC (RR: 1.52, 95% CI: 1.18-1.96, p = 0.001). LBC had a 35% higher abnormal cytology detection rate confirmed by histology (RR: 1.35, 95% CI: 1.20-1.52, p < 0.0001) and a 27% higher detection of confirmed CIN2+ abnormalities (RR: 1.27, 95% CI: 1.11-1.45, p = 0.0006).</p><p><strong>Conclusion: </strong>LBC improves CIN2+ and histology-confirmed abnormal detection rates while reducing unsatisfactory samples, supporting its use in CC screening. SCC detection rates were similar. Findings suggest that LBC, particularly when using FDA-approved tests, enhances glandular abnormality detection. Further research should evaluate its cost-effectiveness in low-resource settings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"10.1159/000552314","url":null,"abstract":"<p><strong>Background: </strong>Precision oncology is often portrayed as a story of genes and drugs, yet it begins with a cell on a slide. This review positions cytopathology as the front door to Molecular Tumor Boards (MTBs), showing how minimally invasive specimens can reliably power comprehensive genomic profiling and guide targeted therapy decisions.</p><p><strong>Summary: </strong>We summarize current evidence and international recommendations to outline a practical, cytology-centered MTB workflow, from case selection and sample triage to technical and clinical validation of molecular alterations, structured reporting, and outcome monitoring. Particular emphasis is placed on pre-analytic variables, nucleic acid yield, 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\" in advanced and difficult to biopsy tumors. We also revise some operational bottlenecks and discuss how integrative pathology can enhance MTB efficiency and equity.</p><p><strong>Key messages: </strong>Cytopathology is the front door to MTBs, enabling minimally invasive specimens to power comprehensive genomic profiling and guide targeted therapy decisions. Pre-analytic variables, nucleic acid yield, and cytomorphologic assessment is determinants of next-generation sequencing success. A practical, cytology-centered MTB workflow from case selection and sample triage to technical and clinical validation of molecular alterations, structured reporting, and outcome monitoring. By reframing cytology from a fallback option to a strategic starting point, this article proposes a model in which cytopathologists co-drive MTB deliberations, enabling timely, evidence-based, and patient-centered precision oncology from the least invasive samples available.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"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}

{"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":"10.1159/000552356","url":null,"abstract":"<p><strong>Introduction: </strong>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 specimens frequently provide the sole diagnostic sample, and their residual supernatants - typically discarded - represent an untapped source of tumor-derived nucleic acids.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"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}

{"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":"10.1159/000552287","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Summary: </strong>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 informs the management of indeterminate diagnoses and facilitates 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.</p><p><strong>Key messages: </strong>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.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"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}

{"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":"10.1159/000552295","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>Voided urine samples, suspected of new-onset bladder cancer, with corresponding pathological diagnosis within 3 months of cytological diagnosis were analyzed. TPS 2.0-based cytology was statistically compared with TPS 1.0- and JRSUC 2015-based ones.</p><p><strong>Results: </strong>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 = 0.972, 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 consistent across 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).</p><p><strong>Conclusion: </strong>Even from the perspective of LGUC, TPS 2.0 would not be disadvantageous and is an excellent reporting system because of objectivity and simplicity.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"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}

{"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":"10.1159/000552244","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent or recurrent cervical lymph node metastases represent a frequent challenge during follow-up of differentiated thyroid carcinoma. 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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"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}

{"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":"10.1159/000552116","url":null,"abstract":"<p><strong>Introduction: </strong>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. 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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>Root cause analysis in discordant cases identifies the key issues that impact cytological diagnostic accuracy.</p><p><strong>Conclusion: </strong>This model can be utilized by any non-gynecologic cytology system to inform accuracy of diagnosis and effectively identify areas of improvement.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.5,"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}

{"title":"The Long and Winding Road: The Resilience of Cervical Cytology as a Long-Standing Laboratory Tool to Aid the Diagnosis of Human Papillomavirus-Induced Lesions.","authors":"Adhemar Longatto-Filho","doi":"10.1159/000552024","DOIUrl":"10.1159/000552024","url":null,"abstract":"<p><strong>Background: </strong>Despite molecular advancements, cervical cytology remains a resilient and fundamental laboratory tool in the prevention of cervical cancer.</p><p><strong>Summary: </strong>This article revisits the historical trajectory of knowledge about human papillomavirus (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.</p><p><strong>Key message: </strong>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.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"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}