Cancer Cytopathology最新文献

{"title":"Current landscape and emerging opportunities for using telecytology for rapid on-site assessment in cytopathology","authors":"Savitri Krishnamurthy MD","doi":"10.1002/cncy.70027","DOIUrl":"https://doi.org/10.1002/cncy.70027","url":null,"abstract":"<p>In recent years, cytopathology practices increasingly are considering the adoption of digital modalities to support remote rapid on-site evaluation (ROSE) of fine-needle aspiration biopsies. Currently, various digital options are available, each of which has unique advantages and limitations. This review covers all relevant aspects of telecytology for ROSE, including digital pathology options, operators, validation, quality assurance, reimbursement, and recommendations from professional organizations. The evolving landscape of telecytology for ROSE, including the development of devices for standardized specimen preparation and staining, next-generation digital microscopy techniques, and deep-learning–based artificial intelligence tools as decision-support aids for the interpretation of digital images, also is outlined.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 7","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300382","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":"The hidden costs of clinical trials","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70021","DOIUrl":"https://doi.org/10.1002/cncy.70021","url":null,"abstract":"&lt;p&gt;Amid the intense controversy over drastic cuts to the National Institutes of Health (NIH) and its workforce, a hotly contested cap on the NIH’s reimbursement of indirect costs for facilities and administrative expenses is focusing new attention on the financial burden of the institutions and trial participants that make clinical research possible.&lt;/p&gt;&lt;p&gt;In 2023, the NIH distributed more than $35 billion in grants to more than 2500 universities and institutions in all 50 states, Washington, DC, and Puerto Rico. That amount included approximately $26 billion to researchers for the direct costs of conducting their work and an additional $9 billion to cover indirect costs, such as maintenance, utilities, rent, personnel, shared facilities, and other necessary expenses borne by the research institutions. As the Association of American Cancer Institutes (AACI) has phrased it, “indirect costs are what ‘keep the lights on’ at many of our nation’s premier research facilities.”&lt;/p&gt;&lt;p&gt;Each institution negotiates its percentage rate for indirect cost reimbursements with the NIH based on factors such as the local rental market and other overhead expenses; the rates generally vary from 30% to 70%. In February 2025, however, the Trump administration announced a new formula capping all reimbursements at 15%, regardless of location. Among the many research organizations decrying the move, the AACI charged that the cut “would be devastating for the patients our cancer centers serve and would stifle progress against cancer.”&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The Trump administration has cast the controversial rule as a cost-conscious move that will save the NIH an estimated $4 billion annually. As a rule of thumb, though, economists have suggested that every $1 spent by the institutes yields roughly $2.50 in economic activity. The cuts, in other words, could wipe out $10 billion in economic activity, resulting in a $6 billion net loss.&lt;/p&gt;&lt;p&gt;Research administrators such as Prakash Nagarkatti, PhD, a professor of pathology, microbiology, and immunology at the University of South Carolina, say that their indirect cost reimbursements are closely tracked and monitored. “It’s not like it just goes into a bucket and disappears,” he says. In a perspective piece in &lt;i&gt;The Conversation&lt;/i&gt;, he and his wife, Mitzi Nagarkatti, PhD, also a professor of pathology, microbiology, and immunology at the university, further assert that the funding cuts will hit hardest in red states, rural areas, and underserved communities.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; To explain why, they point to a huge geographic disparity in which 27 states receive 94% of all NIH funding. That leaves the remaining 6% of funds to be divided among 23 states—including the 18 least populous ones—and Puerto Rico.&lt;/p&gt;&lt;p&gt;Dr Prakash Nagarkatti says that more rural states with smaller economies and a relative lack of investment, infrastructure, medical centers, and research universities can struggle to be competitive in NIH","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197029","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":"“Other” high-risk HPV: Challenges in anal cancer screening","authors":"Margaret L. Compton MD","doi":"10.1002/cncy.70025","DOIUrl":"https://doi.org/10.1002/cncy.70025","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171674","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 diagnostic challenges of medullary thyroid carcinoma: A practical guide for cytopathologists","authors":"Marc P. Pusztaszeri MD,&nbsp;Zahra Maleki MD","doi":"10.1002/cncy.70023","DOIUrl":"https://doi.org/10.1002/cncy.70023","url":null,"abstract":"<p>Medullary thyroid carcinoma (MTC) is a rare but potentially aggressive neuroendocrine tumor arising from the thyroid C cells (parafollicular cells) that produce calcitonin, representing 1%–3% of thyroid malignancies but contributing to up to 15% of thyroid cancer-related deaths. Early detection is critical for improving survival and outcomes because its tumor origin, treatment, and prognosis differ completely from papillary thyroid carcinoma. However, the low incidence of MTC and its variable cytomorphology can pose significant diagnostic challenges for cytopathologists. Referred to as the <i>great mimicker</i>, MTC can resemble various primary and metastatic tumors, complicating its identification, particularly in fine-needle aspiration (FNA) biopsies. Reported FNA sensitivity for a specific MTC diagnosis varies widely from 12.5% to 88.2%, with a 2014 meta-analysis estimating an overall sensitivity of 56.5% when including suspicious lesions. False-negative FNA results, often caused by misinterpretation of cytologic features or inadequate specimen quality, can lead to delayed or suboptimal treatment. Pathologists must be familiar with MTC's diverse cytopathologic presentation and maintain a low threshold for additional diagnostic tests to ensure an accurate preoperative diagnosis. This review article provides practical guidance on diagnosing MTC, emphasizing cytologic features, ancillary studies, mimickers, and common diagnostic pitfalls, serving as a valuable resource for cytopathologists, general pathologists, and trainees to improve diagnostic accuracy and patient care.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148618","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":"Implementing 100% quality control in a cervical cytology workflow using whole slide images and artificial intelligence provided by the Techcyte SureView™ System","authors":"Maria del Mar Rivera Rolon MD, FCAP,&nbsp;Erik Gustafson PhD,&nbsp;Riley Cole BA, MA,&nbsp;Jaylene Matos CT (ASCP), CM,&nbsp;Kellie Hicken CT (ASCP), BS,&nbsp;Jacob Hicks BS, MBA,&nbsp;Brian Cahoon BS, MBA,&nbsp;Mariano de Socarraz,&nbsp;Juan Carlos Santa-Rosario MD, FCAP, FASCP","doi":"10.1002/cncy.70019","DOIUrl":"https://doi.org/10.1002/cncy.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent advancements in digital pathology have extended into cytopathology. Laboratories screening cervical cytology specimens now choose between limited imaging options and traditional manual microscopy. The Techcyte SureView™ Cervical Cytology System, designed for digital cytopathology, was validated at CorePlus, a pathology laboratory in Puerto Rico, and adopted as a 100% quality control (QC) tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The validation study included 1442 whole slide images (WSIs) from 1273 ThinPrep® and 169 SurePath™ cervical cytology slides, digitized with the 3DHISTECH Panoramic 1000 DX scanner using dry and water immersion scanning profiles. These WSIs were processed by the Techcyte SureView™ system, with a board-certified cytopathologist reviewing artificial intelligence (AI)-identified objects of interest and comparing them to traditional light microscopy results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Techcyte SureView™ with the water immersion scanning profile outperformed both the dry scanning profile and light microscopy in detecting squamous and glandular abnormalities. It achieved 97% accuracy, 82% sensitivity, 99% specificity, 98% negative predictive value, and 86% positive predictive value. Additionally, the review time was rapid. The system has been operational for several months, enhancing accuracy and workflow efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that digital cytopathology, particularly through the Techcyte SureView™ system, can improve laboratory workflow and performance. Successful validation led CorePlus to integrate the AI algorithm into their workflow as a 100% QC review tool, resulting in improved accuracy, benefiting both laboratory professionals and patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085455","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":"Evaluating the diagnostic accuracy of imprint and scrape cytology for intraoperative risk stratification of ovarian tumors: A systematic review and meta-analysis","authors":"Mishu Mangla MBBS, MS, PDCC,&nbsp;Seetu Palo MBBS, MD,&nbsp;Anusha Devalla MBBS, MS, DNB,&nbsp;Poojitha Kalyani Kanikaram MBBS, MD","doi":"10.1002/cncy.70024","DOIUrl":"https://doi.org/10.1002/cncy.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate intraoperative assessment of ovarian tumors is crucial for guiding surgical management. The objective of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of imprint and scrape cytology for intraoperative risk stratification of ovarian tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across multiple databases to identify studies that assessed the sensitivity, specificity, positive predictive value, and negative predictive value of imprint and scrape cytology in distinguishing benign and malignant ovarian tumors. Data were pooled using a bivariate random-effects model. The methodological quality of included studies was assessed using the quality assessment of diagnostic accuracy studies 2 tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 34 studies comprising 3318 ovarian tumors were included in the current review. Analysis indicated that the pooled sensitivity of imprint cytology was 89%, whereas the pooled specificity was 92%. The positive and negative likelihood ratios, calculated using a random-effects model, were 8.47 (95% confidence interval [CI], 5.27–13.61) and 0.16 (95% CI, 0.12–0.21), respectively. The pooled diagnostic odds ratio was 63.42 (95% CI, 37.5–107.27). For scrape cytology, the pooled sensitivity and specificity were 89% and 97%, respectively. The positive and negative likelihood ratios were 21.05 (95% CI, 12.36–35.84) and 0.14 (95% CI, 0.09–0.22), respectively. The pooled diagnostic odds ratio was 180.46 (95% CI, 88.01–370.03). Both techniques demonstrated high diagnostic accuracy, and scrape cytology was particularly effective in detecting malignancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Imprint and scrape cytology are valuable intraoperative diagnostic tools for ovarian tumor stratification, offering rapid and reliable results. Their integration into surgical decision making may enhance intraoperative management, particularly in resource-limited settings. Further studies with standardized protocols are needed to refine their clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085350","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":"Impact of race, ethnicity, and human immunodeficiency virus status on anal high-risk HPV subtypes: Preliminary insights from a diverse urban population","authors":"Nikka Khorsandi MD, MPH,&nbsp;Poonam Vohra MD,&nbsp;Peyman Samghabadi MD,&nbsp;Carlo De La Sancha Verduzco MD,&nbsp;Dominic Lung Ct(Ascp),&nbsp;Freddy Chou MS,&nbsp;Steven R. Long MD","doi":"10.1002/cncy.70020","DOIUrl":"https://doi.org/10.1002/cncy.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Racial differences have been identified in the distribution of cervical high-risk human papillomavirus (hrHPV) subtypes; however, there is limited understanding of hrHPV subtypes in anal specimens based on patient race/ethnicity. This knowledge gap limits possible vaccination and/or treatment efforts and may not provide optimal coverage in diverse populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This preliminary study evaluates anal hrHPV subtype distribution and cytological outcomes in a diverse population accessing care at a large, urban, publicly funded hospital over a 2-year period. The primary objectives were to analyze anal hrHPV subtypes and associated cytologic diagnoses, focusing on disparities among demographic groups, including racial and ethnic diversity, and among individuals living with human immunodeficiency virus (HIV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two patients were identified with a predominance of male (87%) and gay-identifying (50%) individuals and a significant representation from Hispanic/Latinx (36%) and White (36%) backgrounds. A majority (88%) were living with HIV, and only a small fraction (7%) had received HPV vaccination. The most common hrHPV subtypes identified were non-16 and 18 hrHPV subtypes (46%). No significant differences were identified in distribution of HPV subtypes among different races/ethnicities or between sexual and gender minorities and heterosexual, cisgender-identifying individuals. However, individuals with HIV were more likely to have atypical cytologic diagnoses and non-16/18 HPV subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings underscore the prevalence of non-16/18 hrHPV subtypes in a racially and ethnically diverse urban population, particularly among individuals living with HIV. The study highlights the need for expanded HPV subtype surveillance and vaccine development to ensure equitable prevention strategies across diverse populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909232","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":"Does artificial intelligence redefine nuclear-to-cytoplasmic ratio threshold for diagnosing high-grade urothelial carcinoma?","authors":"Wei-Lei Yang PhD,&nbsp;Barbara A. Crothers DO,&nbsp;Tien-Jen Liu MD,&nbsp;Shih-Wen Hsu MS,&nbsp;Cheng-Hung Yeh MS,&nbsp;Yi-Siou Liu MS,&nbsp;Guowei Shao MS,&nbsp;Ming-Yu Lin PhD,&nbsp;Tang-Yi Tsao MD,&nbsp;Min-Che Tung MD,&nbsp;Pei-Yi Chu MD,&nbsp;Jen-Fan Hang MD, FIAC","doi":"10.1002/cncy.70017","DOIUrl":"https://doi.org/10.1002/cncy.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Paris System (TPS) introduced standardized nuclear-to-cytoplasmic (N/C) ratio thresholds for urine cytology to improve high-grade urothelial carcinoma (HGUC) detection, but these criteria remain subjective. This study used AIxURO, an artificial intelligence-based model, to measure N/C ratio and nuclear area to identify abnormal cells in whole slide images (WSIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 106 urine cytology slides from 46 lower urinary tract (LUT) and 60 upper urinary tract (UUT) cancer cases, diagnosed as atypical urothelial cell (15.1%), suspicious for high-grade urothelial carcinoma (SHGUC) (23.6%), and HGUC (61.3%), with biopsy-confirmed HGUC or carcinoma in situ (CIS), were digitized and analyzed by AIxURO. The model quantified suspicious and atypical cells, N/C ratios, and nuclear areas, with statistical differences assessed using Kruskal–Wallis tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AIxURO identified fewer suspicious cells than atypical cells (20.5 vs. 242.0, <i>p</i> &lt; .001). Suspicious cells had higher N/C ratios (0.66 vs. 0.58, <i>p</i> &lt; .001) and larger nuclear areas (102.3 vs. 85.7 µm², <i>p</i> &lt; .001). Although N/C ratios did not differ significantly between UUT and LUT cases, nuclear areas varied among abnormal cells (CIS: 101.5 µm²; HGUC: 83.5 µm²). In HGUC cytology cases, the CIS category had larger nuclear areas than HGUC for both suspicious (116.3 vs. 100.4 µm²) and atypical cells (101.5 vs. 82.2 µm²).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AIxURO provides objective quantification of N/C ratios and nuclear areas, refining TPS criteria for distinguishing suspicious from atypical cells. A lower N/C ratio cutoff (0.66) for SHGUC/HGUC may be more appropriate than the TPS threshold (&gt;0.7). Findings support using consistent N/C ratio criteria across UUT and LUT cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902832","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":"Repurposed drugs may lend a new hand as add-ons to existing cancer treatments","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70013","DOIUrl":"https://doi.org/10.1002/cncy.70013","url":null,"abstract":"&lt;p&gt;Despite the inroads made in improving treatments for a wide range of cancers, researchers are coming to grips with the unsettling realization that malignant cells still have a surprising number of escape routes. Block one, and another seems to open up.&lt;/p&gt;&lt;p&gt;Several recent studies, though, have suggested that chemotherapies could be made more effective if combined with drugs initially used for other purposes, such as fighting depression, reducing inflammation, or treating heart failure or pulmonary fibrosis. As add-ons to primary therapeutics, these repurposed drugs may have unexpected additive or synergistic effects that help to block more of the escape routes. As a bonus, many already have been through the lengthy and costly regulatory approval process. This advantage could help researchers to avoid the high costs and long timelines that have slowed the development of novel cancer drugs.&lt;/p&gt;&lt;p&gt;“Combinatory treatments that target the multifaceted oncogenic signaling network hold immense promise,” asserts a recent review of the strategy.1 “Repurposed drugs offer a potential solution to this challenge, harnessing known compounds for new indications.”&lt;/p&gt;&lt;p&gt;In some cases, understanding the environmental niches of cancer cells can help to inform the strategy. One recent study found that adding a drug used to treat idiopathic pulmonary fibrosis to standard chemotherapy increased survival for patients with early-stage HER2-negative breast cancer.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The antifibrotic drug nintedanib seems to work by reducing high levels of fibrosis in the tumor microenvironment. As the study authors noted, “tumor progression has been linked to stiffening of the extracellular matrix caused by fibrosis.” Loosening that extracellular matrix then boosts the effectiveness of the targeted chemotherapy.&lt;/p&gt;&lt;p&gt;Berend Snijder, PhD, a professor at the Botnar Institute of Immune Engineering in Basel, Switzerland, led another study suggesting that an inexpensive antidepressant called vortioxetine can shrink glioblastoma tumors, particularly in combination with existing chemotherapies.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Dr Snijder is an expert in conducting large-scale genetic screens and adapted a high-throughput screening technology to assess how human blood and tissue, including blood cancer samples, would respond to various drugs. With its ability to characterize therapeutic responses at the resolution of a single cell, the technology identified actionable therapies for individual patients, he says.&lt;/p&gt;&lt;p&gt;Based on his initial success, Dr Snijder began asking whether the high-throughput screen might work for solid tumors as well. Several clinical collaborators suggested that he should try it on glioblastoma, which is badly in need of new therapeutic options. “Glioblastoma is not just a terrible disease for patients, but it’s also like a graveyard of failed clinical trials,” he says.&lt;/p&gt;&lt;p&gt;Dr Snijder and his team screened a variety of drugs known to cross the blood","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901085","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":"Selection of neuroendocrine markers in diagnostic workup of neuroendocrine neoplasms: The real-world data and machine learning model algorithms","authors":"Haiming Tang MD, PhD,&nbsp;Haoran Xia PhD,&nbsp;Nanfei Sun PhD,&nbsp;Patricia V. Hernandez MD,&nbsp;Minhua Wang MD, PhD,&nbsp;Adebowale J. Adeniran MD,&nbsp;Guoping Cai MD","doi":"10.1002/cncy.70018","DOIUrl":"https://doi.org/10.1002/cncy.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate diagnosis of neuroendocrine neoplasms (NENs) is challenging, especially in poorly differentiated neuroendocrine carcinomas (NECs). This study was aimed to search the best or best combination of neuroendocrine markers in the diagnostic workup of NENs via analysis of the real-world data and machine learning algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cytology cases with a workup of four neuroendocrine markers (chromogranin, synaptophysin, CD56, and INSM1) were retrieved. Sensitivity, specificity, and area under the curve of receiver operating characteristic curve (AUC-ROC) were calculated for each marker alone or in combination. Two machine learning algorithms, neural network and random forests, were also tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study cohort included 106 NENs (64 NECs and 42 well-differentiated neuroendocrine tumors [NETs]) and 36 non-NEN cases. The combination of synaptophysin and INSM1 had sensitivity of 0.95, specificity of 0.92, and AUC-ROC of 0.93. Addition of CD56 to the combination further increased the sensitivity and AUC-ROC to 1 and 0.96, respectively, in all NENs as well as NEC cases. In addition, the combination of chromogranin, synaptophysin and INSM1 had sensitivity of 1, specificity of 0.92, and AUC-ROC of 0.96 in NETs. Machine learning models, specifically random forests and neural network, confirmed the efficacy of combining synaptophysin, INSM1, and CD56.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of synaptophysin, INSM1, and CD56 has the best performance in diagnostic workup of all NENs, although chromogranin may be selected for NETS. The random forests and neural network models support the common practice rule of requiring at least two out of three markers to be positive for optimal marker utilization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880095","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}