Cancer Cytopathology最新文献

{"title":"Pap testing and high-risk HPV testing for women aged 65 years and older with surgical pathology follow-up.","authors":"Timothy G Ramseyer, Bethany Batson, Daisy Wu, Jonee L Matsko, Amy K Colaizzi, Samer N Khader, Chengquan Zhao","doi":"10.1002/cncy.70111","DOIUrl":"10.1002/cncy.70111","url":null,"abstract":"<p><strong>Background: </strong>Current professional guidelines recommend discontinuing Papanicolaou (Pap) test screening in women aged 65 years and older who have had adequate prior negative testing. However, limited data exist on Pap test performance and histologic outcomes in this population.</p><p><strong>Methods: </strong>Searches were performed for all Pap tests from women aged 65 years and older accessioned at a women's hospital between January 2023 and December 2024. Pap tests were performed using the liquid-based cytology ThinPrep test, and high-risk HPV testing was performed using Aptima high-risk human papillomavirus (HPV) assays. Surgical pathology follow-up within 6 months was recorded. A Pearson χ² test was performed to compare HPV positivity among patients who had abnormal Pap tests.</p><p><strong>Results: </strong>In total, 1536 women aged 65 years and older underwent Pap testing during the study period. The overall HPV-positivity rate was 24.2%. Abnormal Pap results (atypical squamous cells of undetermined significance or worse) comprised 939 of 1536 cases (61.1%). Histologic follow-up was available for 402 cases. Lesions categorized as cervical intraepithelial neoplasia grade 2 (CIN2) or more severe disease were identified in 94 cases (23.3%), including 11 squamous cell carcinomas, three endocervical carcinomas, 40 CIN2/3 lesions, and 40 endometrial carcinomas. Notably, three of 11 squamous cell carcinomas (27.3%) and 12 of 40 CIN2/3 lesions (30%) were HPV-negative.</p><p><strong>Conclusions: </strong>The abnormal Pap rate in women aged 65 years and older was high (61.1%), whereas HPV positivity remained low. CIN2 or more severe disease and endometrial lesions after negative HPV testing occurred at a substantial rate (33.8%). The rate for detecting atypical glandular cells was also elevated (3.0%), correlating with a significant number of endometrial carcinoma diagnoses. These findings underscore the need for additional research and suggest that continued screening with Pap and HPV cotesting may benefit older women.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70111"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the adult standard: Tailoring the WHO Reporting System for Lymph Node Cytopathology to pediatric diagnostics and management.","authors":"Helena Barroca, Fernando Schmitt","doi":"10.1002/cncy.70095","DOIUrl":"10.1002/cncy.70095","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) Reporting System for Lymph Node, Spleen, and Thymus Cytopathology (WHO System) offers a standardized five-category framework to enhance diagnostic consistency. Although globally applicable, its risk of malignancy (ROM) and management protocols are largely generalized. This study explores the system's specific applicability and clinical utility within the pediatric population.</p><p><strong>Methods: </strong>The study presents a pediatric diagnostic pathway centered on fine-needle aspiration biopsy, implemented according to the protocols established by the WHO System. The methodology emphasizes the integration of a multidisciplinary approach. The five WHO categories are evaluated through the lens of pediatric-specific differential diagnoses.</p><p><strong>Results: </strong>In pediatric practice, the Benign category often includes exuberant immunoblastic proliferation (e.g., Epstein-Barr virus) that mimics malignancy. Atypical and Suspicious categories represent a critical \"gray zone\" where the ROM is significantly influenced by the rarity of malignancy. Findings suggest that for Suspicious and Malignant categories, the use of rapid on-site evaluation (ROSE) under optimal conditions allows for an immediate transition to ancillary testing and clinical staging.</p><p><strong>Discussion: </strong>Pediatric application requires shifted interpretive thresholds. Monotonous small cell populations, which might suggest low-grade B-cell lymphoma in adults, typically represent reactive processes or aggressive small round blue cell tumors in children. The interventional pathologist is vital in reducing \"non-diagnostic\" rates. Furthermore, a \"malignant\" or \"suspicious\" diagnosis should trigger immediate multidisciplinary intervention to prevent complications.</p><p><strong>Conclusion: </strong>The WHO System is a robust tool for pediatric evaluation when contextualized within pediatric-specific biological parameters. Integrating ROSE and interventional pathology minimizes invasive procedures and accelerates time-to-treatment for life-threatening malignancies.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70095"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Funding cuts and mixed messages threaten the rise of mRNA vaccine technology: Researchers express deep concern over cuts to the vaccine science that could boost cancer immunotherapy.","authors":"Bryn Nelson, William Faquin","doi":"10.1002/cncy.70096","DOIUrl":"https://doi.org/10.1002/cncy.70096","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70096"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring alternatives to tumor tissue for BRCA1/2 next-generation sequencing testing in high-grade serous ovarian cancer: A 34-case series of malignant ascites.","authors":"Chiara Pighi, Giulio Settanni, Marta Angelini, Laura Bortesi, Valeria Viassolo, Marcello Ceccaroni, Francesco Bruni, Stefania Gori, Gian Franco Zannoni, Anna Pesci","doi":"10.1002/cncy.70102","DOIUrl":"10.1002/cncy.70102","url":null,"abstract":"<p><strong>Background: </strong>BRCA1/2 testing is currently recommended at diagnosis for high-grade serous ovarian carcinoma (HGSOC) because of its impact on patients' survival when treated with poly(adenosine diphosphate ribose) polymerase inhibitors. Standard clinical practice involves analyzing BRCA1/2 genes in formalin-fixed, paraffin-embedded (FFPE) histological specimens. However, because neoplastic ascites is a common clinical presentation in HGSOC and provides a good source of neoplastic cells via a less invasive procedure, it is worthwhile to explore the feasibility of BRCA1/2 testing on cytological specimens obtained from malignant ascites.</p><p><strong>Methods: </strong>BRCA1/2 status was analyzed in 34 ascites-derived cytological samples via an amplicon-based next-generation sequencing (NGS) approach, and the results were compared with those from FFPE tissues previously tested in routine clinical practice.</p><p><strong>Results: </strong>A perfect match was observed between BRCA1/2 testing results from neoplastic ascites and surgical samples (100% concordance) for all pathogenic variants, including both germline and somatic mutations. This is the first study to report such high concordance within the largest collection of somatic variants analyzed to date. Additionally, molecular NGS testing was demonstrated to be feasible even in malignant ascites with a low tumor fraction and with archived material.</p><p><strong>Conclusions: </strong>This study shows that ascites can be a suitable specimen for BRCA1/2 NGS testing, and provides a minimally invasive option for disease diagnosis and the early detection of key molecular biomarkers essential for the clinical management of women with HGSOC.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70102"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assurance for thyroid FNAs: A more useful way to compare performance.","authors":"Andrew A Renshaw","doi":"10.1002/cncy.70099","DOIUrl":"10.1002/cncy.70099","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70099"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrarapid BRAF mutation detection on supernatant cell-free DNA obtained by FNA: An accurate and expedient method for BRAF assessment in aggressive thyroid carcinomas.","authors":"Jose Manuel Gutierrez Amezcua, Maria E Arcila, Dianna L Ng, Rusmir Feratovic, Khawaja Hasan Bilal, Jean Marc Cohen, Xiao-Jun Wei, Brie Kezlarian-Sachs, Carlie S Sigel, Narasimhan Agaram, Khedoudja Nafa, Paulo Salazar, Oscar Lin, David Kim","doi":"10.1002/cncy.70098","DOIUrl":"10.1002/cncy.70098","url":null,"abstract":"<p><strong>Background: </strong>For patients with aggressive thyroid cancer, including anaplastic thyroid carcinoma (ATC) and high-grade follicular cell-derived non-anaplastic thyroid carcinoma, rapid BRAF p.V600E testing is critical as targeted therapy with BRAF/MEK inhibitors significantly improves outcomes. This study assesses the performance and turnaround time (TAT) of the Biocartis Idylla platform for ultrarapid BRAF p.V600E detection across various preparations, emphasizing the use of residual CytoLyt material (supernatant cell-free DNA [ScfDNA]).</p><p><strong>Methods: </strong>All histologically confirmed cases of aggressive thyroid carcinomas received for Idylla testing were identified. Samples were prepared either as ScfDNA, formalin-fixed paraffin-embedded (FFPE) cell block (CB), Diff-Quik smear, or surgical FFPE samples. BRAF p.V600E testing was performed on the Idylla platform, and results were compared to a clinically validated reference method of either next-generation sequencing (NGS) or digital-droplet polymerase chain reaction (ddPCR). TAT for Idylla testing on ScfDNA samples was compared to FFPE preparations and to BRAF V600E immunocytochemistry (ICC).</p><p><strong>Results: </strong>Fifty-seven samples (including 51 ATC) were tested by Idylla. The overall success rate for Idylla was 91%, with ScfDNA at 90% and surgical FFPE specimens at 100%. Of 42 samples that had NGS/ddPCR testing, concordance with the reference method showed 100% agreement (excluding failures) across all sample types. TAT for Idylla on ScfDNA samples was significantly shorter than ICC (median 2.86 vs. 46.7 hrs, p < .05).</p><p><strong>Conclusion: </strong>The Idylla BRAF assay delivers ultrarapid results that are both reliable and accurate with high success rates, particularly on ScfDNA samples. ScfDNA samples also have the fastest TAT because no histologic processing or pre-extraction are required for testing.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70098"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What quality‑assurance metrics best assess the diagnostic performance of pathologists in thyroid fine‑needle aspiration cytology?","authors":"Tarik M Elsheikh, Erika E Doxtader, Rema Chaari","doi":"10.1002/cncy.70101","DOIUrl":"10.1002/cncy.70101","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70101"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fascinating history of papillary thyroid carcinoma nuclei: revelation of two nuclear morphologies-\"Classical papillary\" and \"papillary-like\", with different pathobiologic characteristics.","authors":"N Paul Ohori, Jeremy M Minkowitz, Yuri E Nikiforov, Raja R Seethala","doi":"10.1002/cncy.70100","DOIUrl":"10.1002/cncy.70100","url":null,"abstract":"<p><p>The nucleus of papillary thyroid carcinoma (PTC) has had a fascinating history since its early descriptions by Lindsay in 1960 and his designation of follicular variant papillary thyroid carcinoma (FVPTC) as a subtype of follicular carcinoma (FC). Later, Chen and Rosai revived the awareness of FVPTC and aligned this neoplasm with PTC. From this era, PTC became a nuclear diagnosis and was expanded to include FVPTC, even when noninvasive and encapsulated. However, this practice was prone to interobserver variability. The main issue centered on the interpretation of two types of nuclei: the widely accepted \"classical papillary nucleus\" with well-developed features such as nuclear pseudoinclusions and grooves and the other \"papillary-like nucleus\" with subtle and delicate nuclear features. Subsequently, some individuals recognized papillary-like nucleus in most follicular-patterned neoplasms and diagnosed them as FVPTC, whereas others diagnosed them as follicular adenoma. In the 2000s, noninvasive, encapsulated FVPTC was recognized as an indolent entity, and later relabeled as noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Molecular analyses revealed two main families of drivers for PTC, BRAF V600E or BRAF V600E-like mutations, which aligned with classical papillary nucleus, papillary architecture, and conventional PTC outcomes, and RAS or RAS-like mutations that were associated with papillary-like nucleus, follicular architecture, and follicular-patterned neoplasm outcomes. The story has come full circle, and the recent proposal to incorporate FVPTC into follicular adenoma is in keeping with Lindsay's original concept. By the current understanding, these nuclei are classified better by molecular associations.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70100"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of PLEKHS1 promoter mutation in preoperative thyroid nodule samples.","authors":"Sarah Azad, Timothy E Graham, Shiri Levy, Evana Velanzuela-Sheker, David Bimston, Andrea Ferenczi, Yang Chen, Mohammed Alshalalfa, Yangyang Hao, Joshua P Klopper, Richard T Kloos, Anupam Kotwal","doi":"10.1002/cncy.70103","DOIUrl":"10.1002/cncy.70103","url":null,"abstract":"<p><p>Indeterminate thyroid nodules carry a wide range of malignancy prevalence, necessitating incorporation of molecular testing to guide management. Molecular test results help guide prognosis to a certain extent, but additional prognostic factors need to be identified. Limited data have linked PLEKHS1 promoter (PLEKHS1p) mutations with higher aggressiveness of thyroid cancer. Hence, we aimed to evaluate the diagnostic and prognostic value of PLEKHS1p mutations in preoperative thyroid nodules undergoing molecular testing. We assessed PLEKHS1p mutations in 9279 patient samples from April 2023 to June 2024 among indeterminate thyroid nodules ((B)ethesda III/IV) with Afirma GSC-(S)uspicious results as well as among B V/VI cytology thyroid nodules. We also analyzed a subset of 20 consecutive cases positive for PLEKHS1p mutations with surgical resection for histology and for co-occurring molecular alterations from the Afirma testing. PLEKHS1p mutations were positive in 60/9279 (0.6%) of patient samples with three times higher frequency in B VI compared to B III cytology nodules (1.36% vs 0.47%, p < .01). Among the 60 samples harboring PLEKHS1p mutations, 28 had the C593T hotspot mutation, 38 the G590A mutation, and six samples had both; four samples had concomitant TERTp mutations and 18 samples had concomitant BRAFp.V600E alterations. Our study demonstrated an overall low frequency of PLEKHS1p mutations, but this frequency was highest among malignant (B VI) cytology thyroid nodules. The frequency of PLEKHS1p mutations did not strongly correlate with the severity of thyroid cancer but the surgical sample size was limited. Further research is needed to clarify the role of PLEKHS1p mutations in thyroid nodules and cancer.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":"e70103"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ACR TI-RADS to determine need for repeat FNA in thyroid nodules with nondiagnostic cytology","authors":"Lauren Waters DO,&nbsp;Tiffany M. Cullen DO,&nbsp;Michael B. Goldstein MD,&nbsp;Sheila Sheth MD,&nbsp;Chrystia Slywotzky MD,&nbsp;Shahidul Islam DrPH,&nbsp;Tamar C. Brandler MD, MS,&nbsp;Gary D. Rothberger MD","doi":"10.1002/cncy.70093","DOIUrl":"10.1002/cncy.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nondiagnostic cytology for thyroid nodules, consistent with The Bethesda System for Reporting Thyroid Cytopathology category I (B1) poses a management dilemma for clinicians. The objective of this study was to define the malignancy risk of nodules with B1 cytology using American College of Radiology Thyroid Imaging Reporting &amp; Data System (TI-RADS) and to assess whether TI-RADS can help guide the decision to perform a repeat biopsy of these nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>This retrospective cohort study evaluated 139 B1 nodules that had a definitive diagnosis on repeat biopsy or surgical excision. Sonographic features were evaluated and classified according to TI-RADS. TI-RADS category and total points were compared to the final diagnosis to determine the malignancy risk of B1 thyroid nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 139 nodules, 11 (7.9%) were malignant. The malignancy risk of nodules assigned TI-RADS category 1 and 2 were both 0%, TI-RADS 3 was 2.9%, whereas TI-RADS 4 and 5 were 5.9% and 46.2%, respectively. The optimal cutoff for TI-RADS points predicting malignancy was 5 points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>B1 thyroid nodules in TI-RADS categories 1–3 may not require repeat biopsy given low malignancy risk. However, B1 nodules in TI-RADS categories 4 and 5 have a higher malignancy risk and thus should undergo repeat biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}