{"title":"Geographic Distribution, Number, and Types of Papers Published in International Cytopathology Journals in the Last 5.5 Years: A Perspective from India.","authors":"Jeanne Maria Dsouza","doi":"10.1159/000526767","DOIUrl":"https://doi.org/10.1159/000526767","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 1","pages":"100-101"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10587072","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":"Clinical Impact of Fine Needle Aspiration Cytology on Sentinel Node Biopsy after Preoperative Chemotherapy for Core Needle Biopsy-Proven Metastatic Lymph Nodes.","authors":"Rikiya Nakamura, Shouko Hayama, Satoshi Yoshimura, Makiko Itami, Akinobu Araki, Akiko Odaka, Naohito Yamamoto","doi":"10.1159/000529721","DOIUrl":"https://doi.org/10.1159/000529721","url":null,"abstract":"Introduction: Sentinel node biopsy (SNB) has been increasingly performed for patients with lymph node (LN)-positive (cN1) breast cancer that converted to LN-negative (ycN0) status after neoadjuvant chemotherapy (NAC). This study aimed to clarify the SNB avoidance rates using fine needle aspiration cytology (FNAC) for metastatic LNs after NAC. Methods: This study included 68 patients with cN1 breast cancer undergoing NAC from April 2019 to August 2021. Patients with biopsy-proven metastatic clip-marked LNs (clipped LNs) underwent eight cycles of NAC. Ultrasonography (US) was performed to evaluate the effect of the treatment on the clipped LNs, and FNAC was performed after NAC. Patients with ycN0 status determined using FNAC underwent SNB. Those with positive results for FNAC or SNB underwent axillary LN dissection. Histopathology results and FNA were compared for clipped LNs after NAC. Results: Of the 68 cases, 53 were ycN0 and 15 were clinically positive LNs after NAC (ycN1) on US. Further, 13% (7/53) of all ycN0 and 60% (9/15) of all ycN1 cases showed residual metastasis in the LNs on FNAC. Conclusion: FNAC was diagnostically useful for patients with ycN0 status on US imaging. Using FNAC for LNs after NAC helped avoid unnecessary SNB in 13% of the cases.","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"378-387"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9932116","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":"Discriminant Analysis Using Gabor Filter Sets for Lobular Endocervical Glandular Hyperplasia: Numerical Interpretation of Nuclear Atypia by Gabor Filter Features.","authors":"Fumikazu Kimura, Kengo Ohshima, Keiichiro Shirai, Ryo Kanai, Masaki Sonohara, Keiko Ishii","doi":"10.1159/000533255","DOIUrl":"10.1159/000533255","url":null,"abstract":"<p><strong>Introduction: </strong>Lobular endocervical glandular hyperplasia (LEGH) is a benign lesion; however, it is considered to be the origin of gastric-type adenocarcinoma in the uterine cervix, and early diagnosis is important. At Shinshu University Hospital, screening of LEGH cells is based on the difference in color tone of cytoplasmic mucin on Papanicolaou staining and detection of gastric mucin using HIK1083-labeled latex agglutination assay. However, it is sometimes difficult to distinguish LEGH cells with subtle nuclear atypia from endocervical (EC) cells.</p><p><strong>Methods: </strong>We calculated the Gabor filter features (mean signal value, standard deviation, skewness, kurtosis) from the nuclei of cytological specimens in EC cells (37 cases) and LEGH cells (33 cases) using microscopic images, and we performed statistical analysis and discriminant analysis by linear support vector machine (LSVM) using these features. A Gabor filter is a linear filter defined as a mathematical representation of the mammalian visual system. Gabor filters with three wavelengths and eight angles were used for analysis.</p><p><strong>Results: </strong>Gabor filter features in EC cells were higher than in LEGH cells, demonstrating that the gradient of LEGH cell nuclei was milder than that of EC cell nuclei. The accuracy calculated using all Gabor filters was 91.0% and the accuracy of four Gabor filters (λ = 2/3π and θ = 0°, 45°, 90°, 135°) was 88.9%. High accuracy with low computation costs was achieved by reducing the number of features used for LSVM.</p><p><strong>Conclusion: </strong>The application of a Gabor filter with convolutional processing resulted in the edges of LEGH cells being slightly rough and thick, whereas those of EC cells were fine and thin. Thus, it is thought that the frequency of abrupt gradients of pixels was higher in EC cells than in LEGH cells, and the gradient of chromatin distribution in LEGH cell nuclei was milder than that in EC cell nuclei. It was possible to evaluate nuclear findings of EC and LEGH cells objectively by quantifying morphological features of nuclei using Gabor filters. It was possible to differentiate EC cells from LEGH cells using LSVM using Gabor filter features.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"539-549"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876800","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}
Acta CytologicaPub Date : 2023-01-01Epub Date: 2023-09-26DOI: 10.1159/000534282
Stefania Cannistrà, Francesca Carozzi, Chiara Di Stefano, Marzia Matucci, Giampaolo Pompeo, Giuseppe Gorini, Donella Puliti, Marco Zappa, Cristina Sani, Massimo Confortini
{"title":"Accuracy and Reproducibility of Cytology Triage in a HPV-Based Primary Screening Setting: A Revision of 384 Pap Tests.","authors":"Stefania Cannistrà, Francesca Carozzi, Chiara Di Stefano, Marzia Matucci, Giampaolo Pompeo, Giuseppe Gorini, Donella Puliti, Marco Zappa, Cristina Sani, Massimo Confortini","doi":"10.1159/000534282","DOIUrl":"10.1159/000534282","url":null,"abstract":"<p><strong>Introduction: </strong>After the transition toward the HPV-based screening protocol, which has led to an increase in sensitivity, and in order to bring the specificity back to acceptable values, cytology underwent a change of approach, becoming a triage test. For these reasons, in the Tuscany region (after the recommendations of the GISCi document), it was decided to reduce, as much as possible, the use of ASC-US category in cytology triage, classifying these morphological cases as negative for intraepithelial lesion or malignancies (NILM) or LSIL, basing on the grade of nuclear atypia. So, in Italy, in a cytology triage context (HPV primary screening), a modified Bethesda system (TBS) is currently used. The aim of this study was to evaluate the performance of the review activity of 384 cytology triage cases and of the cervical cancer screening indicators (sensitivity and specificity for CIN2+ lesions) using the TBS 2014 or the modified TBS.</p><p><strong>Materials and methods: </strong>384 HPV positive cases at one-year recall (192 with a cytology result of NILM both at baseline and at one-year recall; 192 with a cytology result of NILM at baseline but abnormal at one-year recall), all with a histologically confirmed result (128 CIN2+, 256 ≤ CIN1), were selected, and their baseline Pap tests were reviewed in blind mode by 5 expert cytologists.</p><p><strong>Results: </strong>The cytological results of NILM were confirmed for 92.5% and 83.8% of cases using TBS 2014 or modified TBS, respectively. 20/128 CIN2+ cases could have been reported at the baseline cytology triage, causing an anticipatory effect and an improvement in sensitivity of the screening protocol at baseline (+15.6%). Using TBS 2014, the number of false positives more than tripled with respect to the modified TBS 2014, with a significant increase in unnecessary colposcopies (+11.4%).</p><p><strong>Conclusion: </strong>This work demonstrated that a greater expertise of cytologists, acquired during the following 3 years of experience with cytological triage, and a strong IQC system could lead to the identification of a significant number of lesions reported to baseline rather than at one-year recall (diagnostic anticipation).</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"618-628"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41104034","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 Application of the Proposed Sydney System for Reporting Lymph Node Cytopathology: A Five-Year Experience of an Academic Institution in South India.","authors":"Sakthisankari Shanmugasundaram, Nandhini Bala Balasubramanian, Abinaya Sundari Amirthakatesan","doi":"10.1159/000530038","DOIUrl":"https://doi.org/10.1159/000530038","url":null,"abstract":"<p><strong>Introduction: </strong>Fine needle aspiration biopsy (FNAB) is a routinely used investigation in the evaluation of lymph node pathologies. However, there exists a lack of uniformity in cytopathology reporting owing to the nonavailability of standard guidelines. Recently, a novel system for reporting lymph node cytopathology has been proposed. The present study aimed to analyze the utility of the proposed system in cytopathology reporting in our institution.</p><p><strong>Materials: </strong>FNABs of lymph nodes performed over a period of 5 years were categorized as per the proposed Sydney system. The diagnoses on cytopathology were correlated with histopathologic diagnoses to assess the diagnostic accuracy. The rate of malignancy (ROM) for each category was calculated.</p><p><strong>Results: </strong>A total of 747 lymph node FNABs were included in the study. Histopathology was available in 262 cases. ROM in categories I-V was 26.3%, 7.2%, 76.9%, 82.3%, and 100.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent benign cytopathology were 84.2%, 97.5%, 97.1%, and 86.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent malignant cytopathology were 92.56%, 95.08%, 94.9%, and 92.8%, respectively.</p><p><strong>Conclusion: </strong>The study substantiates the usefulness of the proposed Sydney system in lymph node cytopathology in enhancing better communication between clinicians and cytopathologists. The use of ancillary techniques like immunocytochemistry and flow cytometry will aid in arriving at a more precise diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"365-377"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286802","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 Future Role of Cytology in Cervical Cancer Screening in the Era of HPV Vaccination.","authors":"Julieta E Barroeta","doi":"10.1159/000528964","DOIUrl":"https://doi.org/10.1159/000528964","url":null,"abstract":"<p><strong>Background: </strong>Up until recently, cervical cytology was the mainstay for cervical cancer screening. However, the established association between human papillomavirus (HPV) infection and cervical cancer has led to changes in preventive strategies, with cytology being replaced by the use of high-risk HPV (hrHPV) testing and primary prevention being achieved by HPV vaccination. In this context, the role of cervical cytology is shifting to secondary triage of HPV-positive women. As vaccination is leading to decreased HPV infections and significant cervical abnormalities (CIN2+), data on the impact of HPV vaccination on cervical cytology metrics, including positive predictive value (PPV) and negative predictive value (NPV), are starting to emerge.</p><p><strong>Summary: </strong>This is a review of updates in cervical cancer screening, including the use of primary HPV testing and the impact of HPV vaccination on cytology as part of cervical cancer screening.</p><p><strong>Key messages: </strong>Cervical cancer screening and prevention are undergoing significant changes as there is widespread implementation of HPV vaccination and hrHPV testing is becoming the entry point for secondary prevention. Optimal screening approaches and intervals in this setting are currently being analyzed including the use of cytology and other ancillary techniques for triage of positive cases, as well as the effect of vaccination on the PPV and NPV of cytology in the detection of CIN2+.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 2","pages":"111-118"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9202910","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":"A Practical Approach to Squamous Abnormalities on Cervical Cytology: Overview of Interpretive Criteria and Guidance for Altering Thresholds in Response to Quality Assurance Findings.","authors":"Michael James Thrall","doi":"10.1159/000528531","DOIUrl":"https://doi.org/10.1159/000528531","url":null,"abstract":"<p><strong>Background: </strong>Squamous intraepithelial lesions observed in Papanicolaou (Pap) test gynecologic cytology arise as a result of infection of the cervicovaginal tract by human papillomavirus (HPV). The viral cytopathic effect of HPV manifests as koilocytosis, also known as low-grade squamous intraepithelial lesion (LSIL) in The Bethesda System (TBS). Integration of HPV genetic material into the genome of squamous cells can, in some women, result in progressive accumulation of mutations and abnormalities of growth and maturation leading to high-grade squamous intraepithelial lesion (HSIL) and possibly invasive squamous cell carcinoma. Due to morphologic overlap between reactive processes and these changes related to HPV, TBS includes equivocal categories that may be applied to Pap tests with uncertain morphology: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot exclude HSIL (ASC-H). Quality assurance (QA) measures in gynecologic cytology laboratories aim to maximize the sensitivity for LSIL and HSIL lesions while simultaneously keeping the use of ASC-US at reasonable levels.</p><p><strong>Summary: </strong>TBS provides a comprehensive nomenclature for squamous abnormalities encountered in screening, but subjectivity in interpretation remains. QA practices attempt to identify problematic patterns of misinterpretation for correction.</p><p><strong>Key message: </strong>This review aimed to provide practical recommendations for cytology practitioners seeking to alter their interpretive thresholds for ASC-US, LSIL, and HSIL in response to feedback from QA procedures indicating deviation from desired norms.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 2","pages":"129-142"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9202938","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}
Acta CytologicaPub Date : 2023-01-01Epub Date: 2023-09-19DOI: 10.1159/000534149
Antti J Hakkarainen, Reija Randen-Brady, Henrik Wolff, Mikko I Mäyränpää, Antti Sajantila
{"title":"Deep Learning Neural Network-Guided Detection of Asbestos Bodies in Bronchoalveolar Lavage Samples.","authors":"Antti J Hakkarainen, Reija Randen-Brady, Henrik Wolff, Mikko I Mäyränpää, Antti Sajantila","doi":"10.1159/000534149","DOIUrl":"10.1159/000534149","url":null,"abstract":"<p><strong>Introduction: </strong>Asbestos is a global occupational health hazard, and exposure to it by inhalation predisposes to interstitial as well as malignant pulmonary morbidity. Over time, asbestos fibers embedded in lung tissue can become coated with iron-rich proteins and mucopolysaccharides, after which they are called asbestos bodies (ABs) and can be detected in light microscopy (LM). Bronchoalveolar lavage, a cytological sample from the lower airways, is one of the methods for diagnosing lung asbestosis and related morbidity. Search for ABs in these samples is generally laborious and time-consuming. We describe a novel diagnostic method, which implements deep learning neural network technology for the detection of ABs in bronchoalveolar lavage samples (BALs).</p><p><strong>Methods: </strong>BALs with suspicion of asbestos exposure were scanned as whole slide images (WSIs) and uploaded to a cloud-based virtual microscopy platform with a neural network training interface. The images were used for training and testing a neural network model capable of recognizing ABs. To prioritize the model's sensitivity, we allowed it to also make false-positive suggestions. To test the model, we compared its performance to standard LM diagnostic data as well as the ground truth (GT) number of ABs, which we established by a thorough manual search of the WSIs.</p><p><strong>Results: </strong>We were able to reach overall sensitivity of 93.4% (95% CI: 90.3-95.7%) in the detection of ABs in comparison to their GT number. Compared to standard LM diagnostic data, our model showed equal to or higher sensitivity in most cases.</p><p><strong>Conclusion: </strong>Our results indicate that deep learning neural network technology offers promising diagnostic tools for routine assessment of BALs. However, at this stage, a human expert is required to confirm the findings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"650-658"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41095037","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}
Acta CytologicaPub Date : 2023-01-01Epub Date: 2023-04-12DOI: 10.1159/000530600
Victoria Psomiadou, Sofia Lekka, Theodoros Panoskaltsis, Helen Tsouma, Natasa Novkovic, Helen J Trihia, Olympia Tzaida, Dimitrios Korfias, Panagiotis Giannakas, Christos Iavazzo, Christos Papadimitriou, Nikolaos Vlahos, George Vorgias
{"title":"Aptima HR-HPV Testing of Cytology Specimens Is an Effective Supplement for p16 Staining to Improve Diagnostic Accuracy for HPV-Related Oropharyngeal Squamous Cell Carcinoma.","authors":"Xin Yang, Chunfang Hu, Huan Zhao, Zhihui Zhang, Linlin Zhao, Jing Yu, Xiaoguang Ni, Huiqin Guo","doi":"10.1159/000527951","DOIUrl":"10.1159/000527951","url":null,"abstract":"<p><strong>Introduction: </strong>Regarding a small proportion of oropharyngeal squamous cell carcinoma (OPSCC) patients who tested p16-positive but human papillomavirus (HPV)-negative, we attempted to perform HPV testing to improve the accuracy of HPV detection in OPSCC patients.</p><p><strong>Methods: </strong>We simultaneously performed Aptima HPV testing of cytological specimens and p16 immunohistochemistry (IHC) staining of histologic biopsies from the same cohort of patients with head and neck SCC (HNSCC). The cytological specimens included fine-needle aspiration specimens from patients with enlarged nodes and endoscopic brushing specimens from the primary lesions of patients without enlarged nodes. Cases with discordant results for p16 IHC staining and Aptima HPV testing were reexamined by a third method, RNAscope testing.</p><p><strong>Results: </strong>Sixty patients with HNSCC (39 OPSCC and 21 non-OPSCC) were recruited for examination of HPV status. Among these patients, 28 were p16+/HPV+, 29 were p16-/HPV-, 2 were p16+/HPV-, and 1 was p16-/HPV+. The overall concordance rate between Aptima HPV testing and p16 IHC was 95.0%. Three cases with discordant results for these two methods were reexamined by RNAscope testing, and all were confirmed to be HPV negative. The prevalence of HPV in OPSCC and non-OPSCC patients was 61.5% (24/39) and 19.0% (4/21), respectively. The sensitivity and negative predictive values of Aptima HPV testing and p16 IHC were consistent at 100%, while the specificity and positive predictive values were 96.9% and 96.6% versus 93.8% and 93.3%, respectively. Additionally, 30 OPSCCs were simultaneously examined and diagnosed by both brush cytology and biopsy pathology; six of these SCCs were underdiagnosed by histopathology but accurately diagnosed by supplemental brush cytology.</p><p><strong>Conclusion: </strong>Aptima HPV testing of cytology specimens can be used as an adjuvant examination to identify false-positive OPSCC patients after p16 IHC of biopsies, while brush cytology may be a supplemental method for the histologic diagnosis of malignant oropharyngeal tumors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 3","pages":"321-332"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623346","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}