Cancer Cytopathology最新文献

{"title":"Correction to “Molecular profiling of thyroid nodules on cytologic samples: Findings from an Italian multi-institutional cohort”","authors":"","doi":"10.1002/cncy.70161","DOIUrl":"10.1002/cncy.70161","url":null,"abstract":"<p>Fiorentino V, Giordano W, Pizzimenti C, et al. “Molecular profiling of thyroid nodules on cytologic samples: Findings from an Italian multi-institutional cohort.” <i>Cancer Cytopathology</i>. 2026; e70065. doi: 10.1002/cncy.70065.</p><p>Support for this work was not included in the original version. It was partially supported by PRIN 2022 – Progetti di Rilevante Interesse Nazionale, project code 20229WCXST, Principal Investigator Luigi Maria Larocca.</p><p>The authors apologize for this error.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179485","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 immunocytochemistry performance in lung cancer cytology: An IASLC Cytology Working Group study","authors":"Deepali Jain MD, FRCPath, FIAC,&nbsp;Irena Srebotnik-Kirbis PhD,&nbsp;Aruna Nambirajan MD, FRCPath,&nbsp;Marianne Engels MD, FIAC,&nbsp;Izidor Kern MD,&nbsp;Tae-Jung Kim MD, PhD,&nbsp;Maria Dolores Lozano MD, PhD,&nbsp;Yuko Minami MD, PhD,&nbsp;Noriko Motoi MD, PhD,&nbsp;Mauro Papotti MD,&nbsp;Natasha Rekhtman MD, PhD,&nbsp;Anjali Saqi MD,&nbsp;René Schönegg MD,&nbsp;Murry W. Wynes PhD,&nbsp;Yasushi Yatabe MD, PhD,&nbsp;Lukas Bubendorf MD,&nbsp;IASLC Pathology Committee Members","doi":"10.1002/cncy.70159","DOIUrl":"10.1002/cncy.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immunohistochemistry (IHC) is essential for tumor subtyping and predictive biomarker analysis in non–small cell lung carcinoma (NSCLC). When only cytological material is available and no concurrent biopsy or cell block exists, immunocytochemistry (ICC) may need to be performed on slides prepared using diverse fixation protocols, introducing substantial pre-analytical variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven laboratories representing commonly used cytology fixation protocols were selected based on an exploratory global survey of 63 institutions. Two central laboratories prepared direct smears, cytospins and provided cells in PreservCyt from specimens with confirmed marker expression using the selected fixation protocols. Materials were distributed for immunocytochemical demonstration of TTF-1, p40, <i>ALK</i>, and ROS1 according to local protocols. Digitized slides were independently evaluated using standardized four-tier scoring criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A total of 105 stained slides from 17 study runs were assessed. Delaunay-fixed, Papanicolaou-stained, and methanol-fixed polyethylene glycol-coated preparations demonstrated consistently superior ICC performance compared with other evaluated fixation protocols. In contrast, high rates of suboptimal staining were observed with PreservCyt fixation (81.8%) and air-dried preparations (58.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that fixation protocol significantly impacts ICC performance on non–cell block cytological preparations. The observed fixation-dependent differences underscore the need for harmonized pre-analytical practices, robust local validation, and external quality assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165701","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":"Preanalytical variables affect predictive immunohistochemical biomarker testing in non–small cell lung carcinoma cytology specimens","authors":"Saroja Devi Geetha MD,&nbsp;Wei-Lien Wang MD,&nbsp;Neda Kalhor MD,&nbsp;Sinchita Roy-Chowdhuri MD, PhD","doi":"10.1002/cncy.70160","DOIUrl":"https://doi.org/10.1002/cncy.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several therapeutic targets for non–small cell lung carcinoma (NSCLC) rely on protein expression by immunohistochemistry (IHC). Most biomarkers are validated on formalin-fixed, paraffin-embedded (FFPE) tissue; however, cytologic specimens, including cell blocks (CBs), that are subject to preanalytical variables are increasingly used. The objective of this study was to evaluate predictive IHC biomarkers in NSCLC CBs and compare them with surgical pathology (SP) specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors retrospectively reviewed NSCLC cytology specimens that underwent predictive IHC testing for hepatocyte growth factor receptor (c-MET), human epidermal growth factor receptor 2 (HER2), and programmed death-ligand-1 (PD-L1) between January 2019 and June 2025. IHC was performed on CBs that were centrifuged with equal amounts of ethanol and formalin before FFPE processing. Equal numbers of NSCLC SP specimens with available biomarker testing were included for comparison. Predictive IHC scores that were considered therapy-eligible were c-MET IHC 3+, HER2 IHC 3+, and PD-L1–positive tumor proportion scores. Statistical analyses were performed using the Fisher exact test, with <i>p</i> &lt; .05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 414 cases (cytology specimens, <i>N</i> = 212; SP specimens, <i>N</i> = 212 [60% biopsy, 40% resection]). Cytology specimens demonstrated a significantly higher proportion of strong 3+ c-MET expression (40%) compared with SP specimens (10%; <i>p</i> &lt; .0001). Similarly, high PD-L1 expression was more frequent in cytology specimens (32% vs. 20%; <i>p</i> = .0079). HER2 expression was similar between groups, with no significant difference in HER2 IHC 3+ rates (<i>p</i> = .34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Predictive IHC testing is performed on NSCLC cytology to identify patients for therapeutic targets. The current study highlights the need for optimizing preanalytical variables in cytology specimen processing, even when testing FFPE CBs, to ensure the reliability of predictive IHC results that guide therapeutic decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149125733","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":"Stromal edge involvement in FNB of pancreatic ductal adenocarcinoma: An important diagnostic clue","authors":"Dina Zenezan MD,&nbsp;M. Lisa Zhang MD,&nbsp;Martha Pitman MD","doi":"10.1002/cncy.70157","DOIUrl":"10.1002/cncy.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>SharkCore fine-needle biopsy (FNB) provides ample intact tissue for rapid on-site evaluation and ancillary studies. Diagnosing well-differentiated pancreatic ductal adenocarcinoma (PDAC) remains challenging, particularly in the absence of stromal invasion. The diagnostic significance of edge involvement (EI), defined as ductal epithelial cells at the edge of stromal fragments, in SharkCore FNB specimens of PDAC, was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A total of 42 PDAC FNBs were reviewed over a 1-year period. Smears and corresponding histology specimens were evaluated for the presence of EI, stromal invasion, and detached background tumor cells. Histology specimens were classified as low-grade (well/moderately differentiated) or high-grade (poorly differentiated). A benign cohort of 27 pancreatic FNBs was included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On smears, EI was identified in 39/42 (92.9%), stromal invasion in 22/42 (52.4%), and detached background tumor cells in 41/42 (97.6%) cases. On histology, EI was present in 38/42 (90.5%), stromal invasion in 32/42 (76.2%), and background tumor cells in 37/42 (88.1%) cases. One case showing EI was initially interpreted as benign but was found to be a low-grade PDAC on repeat FNB. On histology, EI without stromal invasion was observed in 7/26 low-grade tumors, whereas stromal invasion with EI was present in 15/16 high-grade tumors. In the benign cohort, EI was absent on histology but identified in 2/27 smears (7.4%), both lacking follow-ups. EI was significantly more frequent in PDAC, with sensitivity/specificity of 92.9%/92.6% in smears and 90.5%/100.0% in histology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EI is a specific diagnostic clue for PDAC that improves diagnostic confidence, particularly in low-grade tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104486","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":"Diagnostic accuracy of methylthioadenosine phosphorylase immunohistochemistry for CDKN2A homozygous deletion and for distinguishing mesothelioma from reactive mesothelial proliferations: A systematic review and bivariate meta-analysis","authors":"Vishal Tayade MD,&nbsp;Gyanendra Singh MD","doi":"10.1002/cncy.70155","DOIUrl":"https://doi.org/10.1002/cncy.70155","url":null,"abstract":"<p>Distinguishing mesothelioma from reactive mesothelial proliferations is a recurring problem in serous effusion and small-biopsy practice, where invasion cannot be assessed and diagnosis rests on cell block immunohistochemistry. Loss of methylthioadenosine phosphorylase (MTAP) immunostaining is an inexpensive surrogate for <i>CDKN2A</i> homozygous deletion; however, its accuracy used alone has not been quantified. This is a systematic review of diagnostic test accuracy studies (PRISMA-DTA, QUADAS-2, and Open Science Framework). Four databases were searched to June 18, 2026. Eligible studies reported MTAP immunohistochemistry alone with an extractable 2 × 2 table against <i>CDKN2A</i> homozygous deletion (primary reference) or the integrated mesothelioma-versus-reactive diagnosis (secondary). Bivariate/hierarchical summary receiver operating characteristic (HSROC) meta-analysis used mada, with a prespecified univariate summary where specificity approached 100%. Nineteen studies contributed 21 two-by-two tables, five of nine secondary arms being effusion cytology cell blocks. Against <i>CDKN2A</i> homozygous deletion (seven studies), pooled sensitivity was 75.9% (95% CI, 56.6%–88.4%) and specificity was 79.4% (95% CI, 65.8%–88.6%); the area under the HSROC curve (AUC) was 0.845. For mesothelioma versus reactive proliferations (nine pleural arms), pooled sensitivity was 52.0% (95% CI, 44.4%–59.5%), with specificity at or near 100% (bivariate sensitivity, 51.7%; bivariate specificity, 95.5%; AUC, 0.758). Peritoneal data were too sparse to pool (one cohort; sensitivity, 33.3%). Sensitivity did not differ by specimen format (histology, 51.6%; effusion cytology, 52.9%). MTAP immunohistochemistry shows useful but imperfect concordance with <i>CDKN2A</i> homozygous deletion, and high specificity for the mesothelioma-versus-reactive distinction. On a cell block or small biopsy, a confident complete-loss call is essentially specific for malignancy; molecular confirmation by fluorescence in situ hybridization, copy number analysis, or a next-generation sequencing panel should be retained where MTAP is equivocal or uninterpretable, and for peritoneal disease.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145637","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 remarkable axolotl is helping to advance cancer research","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70151","DOIUrl":"10.1002/cncy.70151","url":null,"abstract":"&lt;p&gt;In 1864, naturalists shipped a group of 34 axolotl salamanders from their native Mexico to Paris, where the strange amphibians became attractions in two Parisian zoos.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The axolotls thrived, multiplied, and soon populated laboratories, zoos, and home aquariums throughout the world—a sharp contrast to their decline in the wild. Unlike many other salamanders, the axolotl proved easy to house and breed: It stays in its larval stage throughout its life, remains fully aquatic with six feathery gills fanning out behind its head, and mates throughout the year.&lt;/p&gt;&lt;p&gt;More than 160 years later, the “Peter Pan of salamanders” is critically endangered in Mexico, a popular laboratory animal around the globe, and a growing source of tantalizing insights in cancer research. Although it has only partly divulged its many secrets, the axolotl has revealed new clues about its remarkable ability to regrow entire limbs, organs, and even parts of its brain and heart while supplying an expanding list of anticancer peptides and extracts.&lt;/p&gt;&lt;p&gt;The axolotl is normally dark brown in the wild but exists in a wide array of color variants in captivity, including an intentional cross-mating with an albino tiger salamander in 1964 that yielded a nearly translucent (and easier to study) albino axolotl. Joshua Currie, PhD, assistant professor of biology at Wake Forest University in Winston-Salem, North Carolina, says that the unusual salamander species has been a compelling model for studying tissue regeneration. “As a cell biologist, I was really fascinated with this idea that cells sometimes work together in collectives to do pretty extraordinary things, and I think regeneration is one of the most extraordinary things that cells do as a cohort.”&lt;/p&gt;&lt;p&gt;In a recent study of axolotls, zebrafish, and mice, Dr Currie and his colleagues discovered that two highly conserved gene-activating transcription factors appear to play a critical role in regenerating the tips of digits in mice and of entire limbs in axolotls.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The SP6 and SP8 factors, members of the SP family, were previously known to be involved in embryonic development. Researchers found that they were also highly active in the animals’ skin during tissue regeneration. “That was really intriguing: that this core set of transcription factors is in the regenerating skin of all three organisms,” Dr Currie says. “So that was quite cool, and then we went about trying to figure out, are they essential for this process?”&lt;/p&gt;&lt;p&gt;When the team specifically knocked out the SP8 gene in axolotls, they found that its deletion had no apparent impact on the animals’ embryonic development. Conversely, the gene knockout led to significant disruptions in tissue regeneration after an amputation. “That was very cool for us, to find a regeneration-specific role for SP8,” Dr Currie says. Knockouts of the &lt;i&gt;Sp6&lt;/i&gt; or &lt;i&gt;Sp8&lt;/i&gt; genes similarly disrupted digit regrowth in mice, whereas the resear","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073525","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":"Thank You to Reviewers 2026","authors":"","doi":"10.1002/cncy.70158","DOIUrl":"https://doi.org/10.1002/cncy.70158","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146513","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":"Western versus Asian utilization of molecular testing for indeterminate thyroid nodules: A meta-analysis of divergent clinical impact","authors":"Chanchal Rana MD,&nbsp;Truong Phan-Xuan Nguyen MD,&nbsp;Chan Kwon Jung MD, PhD,&nbsp;Andrey Bychkov MD, PhD,&nbsp;Kennichi Kakudo MD, PhD","doi":"10.1002/cncy.70154","DOIUrl":"10.1002/cncy.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Molecular testing (MT) aids in the management of indeterminate thyroid nodules; however, regional differences remain unexamined. This meta-analysis compares MT's clinical impact between Western and Asian cohorts. This study hypothesized that regional disparities in malignancy prevalence, molecular platforms, and practice patterns would yield divergent clinical applications of MT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review up to April 2025 identified studies reporting the surgical management and histopathological outcomes of indeterminate nodules in Asian and Western cohorts, stratified by use of MT versus no MT. Pooled proportions were calculated via random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 127 included studies (100 Western; 27 Asian), MT was performed in 96 Western and 21 Asian studies. Western studies predominantly used commercial panels, whereas Asian studies favored smaller, mutation-specific assays. Without MT, resection rates were 66.8% (95% CI, 55.1%–76.7%) in Western studies versus 53.9% (95% CI, 43.5%–64.0%) in Asian studies (<i>p</i> = .11). With MT, rates fell to 42.5% versus 37.4% (<i>p</i> = .275), respectively. Risk of malignancy (ROM) was significantly higher in Asian cohorts, both without MT (48.0% vs. 29.5%; <i>p</i> = .005) and with MT (62.7% vs. 37.1%; <i>p</i> &lt; .001), which persisted after exclusion of follicular thyroid neoplasm with papillary-like nuclear features. In Western studies, second-generation platforms achieved lower resection rates (36.1% vs. 48.3%; <i>p</i> = .001) but higher ROM (42.8% vs. 34.4%; <i>p</i> = .005) than first-generation tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MT reduces surgical interventions across both regions by serving divergent roles. In the West, MT functions as a rule-out tool to avoid surgery via comprehensive panels. In Asia, where baseline malignancy is higher and practice is relatively conservative, MT provides confirmatory risk stratification via focused mutation panels. Regionally tailored guidelines are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030007","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":"Artificial intelligence–assisted digital thyroid FNA cytology: Improved agreement and sensitivity for higher-risk Bethesda categories with enhanced screening efficiency","authors":"Swati Satturwar MD,&nbsp;Zaibo Li MD, PhD,&nbsp;Chi-Shun Yang MD,&nbsp;Yi-Jyun Lin MS,&nbsp;Wei-Lei Yang PhD,&nbsp;Ming-Yu Lin PhD,&nbsp;Cheng-Hung Yeh MS,&nbsp;Shih-Wen Hsu BS,&nbsp;Yi-Siou Liu MS,&nbsp;Guowei Shao MS,&nbsp;Tien-Jen Liu MD,&nbsp;Chih-Jung Chen MD, PhD,&nbsp;Barbara A. Crothers DO","doi":"10.1002/cncy.70149","DOIUrl":"10.1002/cncy.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate cytologic classification of thyroid nodules is essential for clinical management, but interobserver variability and indeterminate interpretations remain persistent challenges. The clinical feasibility of AIxTHY, a disease-specific deep-learning algorithm integrated into a digital cytology platform, was evaluated for assisting thyroid fine-needle aspiration (FNA) diagnosis using whole-slide imaging (WSI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two cytopathologists and one cytologist independently reviewed 100 archival ThinPrep FNA slides using three modalities: microscopy, artificial intelligence (AI)–assisted single-layer WSI (S-WSI), and AI-assisted seven-layer Z-stack WSI (7-WSI), with 2-week washout intervals. Reviewers assigned The Bethesda System (TBS) categories, and review times were recorded. Diagnoses were compared with expert cytologic consensus as ground truth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AI-assisted review modalities improved overall agreement with consensus diagnoses, particularly for higher-risk categories (TBS III+: atypia of undetermined significance, follicular neoplasm, and malignant), and reduced downgrading compared to microscopy. For binary risk stratification (TBS III+ vs TBS II), AI assistance increased sensitivity from 60% to 78% to 79% and accuracy from 61% to approximately 71%, whereas specificity decreased because of increased false-positive classifications, particularly among indeterminate cases. AI-assisted review significantly reduced slide review time by 40% to 65% across diagnostic categories (<i>p</i> &lt; 0.01), with the greatest efficiency gains in positive cases. Compared with S-WSI, 7-WSI did not further improve diagnostic concordance or binary classification performance but provided additional reductions in review time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AIxTHY is a feasible adjunct for improving detection and workflow efficiency in digital thyroid cytopathology, although further refinement is needed to improve specificity in indeterminate lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029988","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":"Refining risk stratification after indeterminate urinary cytology: Evidence from Bladder EpiCheck","authors":"Claudia Mercader MD,&nbsp;Mercedes Ingelmo-Torres PhD,&nbsp;Fiorella L. Roldán MD, PhD,&nbsp;Marcel Figueras MSc,&nbsp;Eric Villalba MD,&nbsp;Pilar Galve RN,&nbsp;Ignacio Asiaín MD,&nbsp;Meritxell Costa MD,&nbsp;Antoni Vilaseca MD, PhD,&nbsp;Josep Oriola PhD,&nbsp;Agustín Franco MD, PhD,&nbsp;Antonio Alcaraz MD, PhD,&nbsp;Lourdes Mengual PhD","doi":"10.1002/cncy.70141","DOIUrl":"https://doi.org/10.1002/cncy.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to evaluate Bladder EpiCheck (BE) performance in detecting urothelial carcinoma (UC) and HG (high-grade) events in patients with indeterminate cytology and negative cystoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 63 patients who presented with indeterminate urinary cytology and negative cystoscopy between October 2022 and April 2024. A repeated urine sample was obtained and analyzed via both urinary cytology and BE test. Patients were followed for 1 year. The diagnostic performance of each test was assessed. Logistic regression models were developed to estimate the risk of UC and HG events on the basis of repeated cytology and BE results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two patients (51%) experienced a UC event, of which 25 (78%) were HG events. Sensitivity (SN) for detecting UC events was significantly higher (80% vs. 17%; <i>p</i> &lt; .001) for BE compared to repeated urinary cytology, whereas repeated cytology demonstrated higher specificity (SP) (59% vs. 96%; <i>p</i> = .02). Similar SN differences were observed for HG disease (80% vs. 25%; <i>p</i> &lt; .001). However, when suspicious for high-grade urothelial carcinoma was considered a positive cytology result, no statistically significant differences were observed between BE and repeated cytology in either SN or SP. A prognostic model combining repeated cytology and BE outperformed models using baseline cytology combined with either test alone in predicting UC and HG events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with indeterminate urinary cytology and negative cystoscopy, BE provided complementary diagnostic information for the detection of UC events and HG disease. The combination of BE and repeated urinary cytology provided the most accurate risk assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 10","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148903965","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}