Cancer Cytopathology最新文献

{"title":"Cytology-Radiology Correlation Series: Thyroid cytopathology","authors":"Rachel Jug MB, BCh, BAO,&nbsp;Wen-Chi Foo MD,&nbsp;Benjamin Wildman-Tobriner MD,&nbsp;Xiaoyin “Sara” Jiang MD","doi":"10.1002/cncy.70028","DOIUrl":"https://doi.org/10.1002/cncy.70028","url":null,"abstract":"<p>Thyroid ultrasound is typically the first step in the workup of thyroid nodules. Ultrasonographic features of thyroid nodules can be used to evaluate their risk of malignancy using risk stratification systems to determine whether a nodule is suspicious enough to warrant a more invasive fine-needle aspiration (FNA) for further evaluation. For this review, the authors described and compared two major risk stratification systems, the American Thyroid Association classification system and the American College of Radiology Thyroid Imaging Reporting and Data System, and explored corresponding ultrasound and cytology findings in the thyroid for commonly encountered entities in cytopathology practice.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681092","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":"Hepatocyte nuclear factor 4 alpha immunocytochemistry: A useful marker for detecting endocervical glandular lesions in alcohol-fixed smears","authors":"Yuri Noda DDS, PhD,&nbsp;Kaori Sando CT,&nbsp;Masato Kita MD, PhD,&nbsp;Koji Tsuta MD, PhD","doi":"10.1002/cncy.70034","DOIUrl":"https://doi.org/10.1002/cncy.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatocyte nuclear factor 4 alpha (HNF4α) contributes to tumorigenesis and cancer progression. This study evaluated the diagnostic potential of HNF4α for detecting endocervical glandular lesions (EGLs), including endocervical adenocarcinomas (ECAs), adenocarcinomas in situ (AIS), and lobular endocervical glandular hyperplasias (LEGH) using alcohol-fixed cytological smears.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HNF4α expression was immunocytochemically assessed in alcohol-fixed smears and paired formalin-fixed paraffin-embedded tissue specimens obtained from 14 patients with histologically confirmed EGLs: eight papillomavirus-associated (HPVA) ECAs, one non-NHPVA ECA, two HPVA AIS, and three patients with LEGHs. Three cases of squamous cell carcinomas (SCCs) and two cases of non-neoplastic lesions were also analyzed as non-EGL controls. HNF4α positivity was defined as nuclear staining in one or more cell(s)/slide, regardless of intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histologically confirmed EGL cases were cytologically diagnosed as four adenocarcinomas, eight atypical glandular cells, one misclassified atypical squamous cells of undetermined significance, and one misclassified SCC, with a sensitivity of 85.7% and specificity of 100%. Strong and diffuse nuclear HNF4α expression was observed in atypical glands in both smears and tissue specimens, whereas non-neoplastic glands and non-neoplastic/neoplastic squamous epithelium were HNF4α-negative. HNF4α expression showed 73.7% concordance between tissue and smear samples. Notably, HNF4α immunocytochemistry demonstrated 100% sensitivity and specificity for detecting EGLs, outperforming cytomorphological or immunohistochemical diagnosis (sensitivity, 71.4%; specificity, 100%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HNF4α is a reliable diagnostic marker when using alcohol-fixed smears, showing enhanced accuracy for EGLs detection regardless of human papillomavirus status. Immunocytochemical analysis of HNF4α in cervical smears can be used for EGL detection and early diagnosis of cervical cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666511","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":"Diagnostic accuracy and risk stratification of pancreatic cyst fluids diagnosed as mucinous neoplasms without mucinous epithelium","authors":"Priscila Dias Goncalves MD,&nbsp;M. Lisa Zhang MD","doi":"10.1002/cncy.70030","DOIUrl":"https://doi.org/10.1002/cncy.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neoplastic mucinous cysts (NMC) are premalignant lesions that can be diagnosed on pancreatic cyst fluid (PCF) based on elevated carcinoembryonic antigen or thick extracellular mucin (ECM) without mucinous epithelium. Under the World Health Organization classification, such cases are considered “pancreaticobiliary neoplasm, low-risk/grade.” This study evaluates the diagnostic accuracy and risk of cysts diagnosed as NMC without mucinous epithelium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>A total of 609 PCF specimens (493 patients) diagnosed as NMC were identified; 279/609 (45.8%) had no mucinous epithelium: 182 and 61 were diagnosed based only on elevated carcinoembryonic antigen ≥192 ng/mL or ECM, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among PCF without mucinous epithelium and with molecular correlation, 110/165 (66.7%) harbored <i>KRAS/GNAS/RNF43</i> mutations. High-risk mutations (<i>TP53</i>/<i>CDKN2A</i>/<i>SMAD4</i>) occurred at similar rates in cysts with low-grade mucinous epithelium as in those without mucinous epithelium (6.5% vs. 3.6%, <i>p</i> = .224). A total of 63/71 (88.7%) resections from cysts without mucinous epithelium were confirmed as NMC: 40 (56.3%) had low-grade dysplasia and 23 (32.4%) had at least high-grade dysplasia. A total of 142/279 (50.9%) PCF without mucinous epithelium were molecularly or histologically confirmed as NMC. No significant differences were found in the rates of new worrisome radiologic features, invasive carcinoma, or disease-related mortality between the groups. Patient survival trended lower in the cohort with mucinous epithelium, though rates were comparable upon subanalysis of only “pancreaticobiliary neoplasm, low-risk/grade” cysts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Even though PCF diagnosed as NMC without mucinous epithelium defaults to a low-risk category, the rates of high-grade neoplasia/high-risk outcomes are comparable to those with low-grade mucinous epithelium, supporting continued utility of carcinoembryonic antigen and ECM as diagnostic criteria for NMC in the absence of mucinous epithelium.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589706","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 performance of SHOX2 and RASSF1A gene methylation assays in malignant pleural effusion: A systematic review and meta-analysis","authors":"Mohamed Smail Aissani MD,&nbsp;Kyrillos Mahrous Gerges MD,&nbsp;Ahmed Msherghi MD,&nbsp;Hajer Farrara MD,&nbsp;Dawood Alatefi MD,&nbsp;Imane Chenfouh MD,&nbsp;Arwi Omar Kara MBBCh,&nbsp;Maram Abuajamieh MBBCh,&nbsp;Ghada Kareem MBBCh,&nbsp;Mohammed Benhammou MD,&nbsp;Mohamed E. Ali MD,&nbsp;Max Wintermark MD, MAS,&nbsp;Muhammed Elhadi MBBCh, MSc","doi":"10.1002/cncy.70031","DOIUrl":"https://doi.org/10.1002/cncy.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malignant pleural effusion (MPE) is a common complication of advanced malignancies, requiring differentiation from benign pleural effusion for appropriate management. Cytology and biopsy have limitations, necessitating more sensitive, less invasive diagnostic techniques. The objective of this study was to evaluate the diagnostic accuracy of methylated <i>SHOX2</i> (short-stature homeobox 2) and <i>RASSF1A</i> (Ras association domain family member 1A) genes in detecting MPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis included studies that compared benign pleural effusion and MPE cohorts using methylation of <i>SHOX2</i> and <i>RASSF1A</i> genes in pleural fluid as the index test and cytology/histopathology as the reference standard. A random-effects model was used to calculate sensitivity, specificity, predictive values, and diagnostic odds ratios. Subgroup analysis assessed performance in lung-predominant versus nonlung-predominant MPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four studies with a total of 534 participants were included. The pooled sensitivity and specificity were 85% (95% confidence interval [CI], 53%–96%; heterogeneity [I²] = 0.00%) and 92% (95% CI, 88%–95%; I² = 24.8%), respectively. The positive and negative predictive values were 93% (95% CI, 85%–97%; I² = 61.5%) and 84% (95% CI, 53%–96%; I² = 0.00%), respectively. The diagnostic odds ratio was 22.78 (95% CI, 11.00–47.17; I² = 25.8%). Subgroup analysis showed a slight decrease in sensitivity (70%; 95% CI, 64%–76%; I² = 0.00%) and specificity (91%; 95% CI, 86%–94%; I² = 26.1%) when excluding the study with a lung cancer-predominant population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combined analysis of <i>SHOX2</i> and <i>RASSF1A</i> methylation demonstrated promising diagnostic accuracy for MPE detection, outperforming cytology. This less invasive method could reduce reliance on more invasive procedures, although further research is needed to confirm its efficacy across diverse populations and cancer types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558195","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":"DICER1 mutations in Bethesda category II, III, and IV thyroid nodules: A mutually exclusive relationship with BRAFV600E mutation","authors":"Yulian Wang MS,&nbsp;Guangqi Li MS,&nbsp;Weimao Kong MS,&nbsp;Jianxia Hu MD,&nbsp;Longnv Bao MS,&nbsp;Xingzhu Pan MS,&nbsp;Xueqing Li MS,&nbsp;Jigang Wang MD, PhD","doi":"10.1002/cncy.70029","DOIUrl":"https://doi.org/10.1002/cncy.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the prevalence and cytological features of <i>Dicer 1</i>, <i>Ribonuclease III</i> (<i>DICER</i>)-mutant fine-needle aspiration (FNA) specimens in thyroid nodules classified as Bethesda II, III, and IV categories. The authors also sought to explore the relationship between <i>DICER1</i> and <i>BRAF</i>^V600E mutations in Bethesda III thyroid nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors collected a series of consecutive FNA cases diagnosed as Bethesda category II, III, and IV from a medical center over the course of 1 year. <i>DICER1</i> exons 24 and 25 and <i>TERT</i> promoter mutations were detected by Sanger sequencing in all cases, and <i>BRAF</i>^V600E mutations were detected by amplification refractory mutation system PCR in Bethesda III and IV cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 899 patients were included in the study. <i>DICER1</i> mutations were identified in 52 patients: 20 in Bethesda category II (6.2%, 20 of 322), 25 in Bethesda category III (4.9%, 25 of 510), and seven in Bethesda category IV (10.4%, 7 of 67). Among the 510 Bethesda III FNA samples, 76 harbored the <i>BRAF</i>^V600E mutation and 25 harbored <i>DICER1</i> mutations. <i>BRAF</i>^V600E and <i>DICER1</i> mutations were mutually exclusive. In Bethesda category II and III cases, patients with <i>DICER1</i>-mutant nodules were younger and had larger nodule volumes compared to those without <i>DICER1</i> mutations. All <i>DICER1</i>-mutant Bethesda III FNAs were classified as atypia of undetermined significance (AUS)-other. <i>TERT</i> promoter mutations (c. -118G&gt;T and c. -144 C&gt;T) were identified in two FNA samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study suggest that <i>DICER1</i>-mutant nodules are unlikely to be <i>BRAF</i>-mutant carcinomas. Further study of the molecular characteristics of <i>DICER1</i>-mutant FNAs will contribute to more accurate cytological diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551026","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":"Assessment of the efficacy and accuracy of cervical cytology screening with the Hologic Genius Digital Diagnostics System","authors":"Esther Elishaev MD,&nbsp;Lakshmi Harinath MD,&nbsp;Yuhong Ye MD, PhD,&nbsp;Jonee Matsko SCT, MB,&nbsp;Amy Colaizzi SCT,&nbsp;Stephanie Wharton SCT,&nbsp;Rohit Bhargava MD,&nbsp;Liron Pantanowitz MD, PhD, MHA,&nbsp;Matthew G. Hanna MD,&nbsp;Sarah Harrington PhD,&nbsp;Chengquan Zhao MD, PhD","doi":"10.1002/cncy.70022","DOIUrl":"https://doi.org/10.1002/cncy.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical technologies powered by artificial intelligence are quickly transforming into practical solutions by rapidly leveraging massive amounts of data processed via deep learning algorithms. There is a necessity to validate these innovative tools when integrated into clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study evaluated the performance of the Hologic Genius Digital Diagnostics System (HGDDS) with a cohort of 890 previously reviewed and diagnosed ThinPrep Papanicolaou (Pap) tests with the intent to deploy this system for routine clinical use. The study included all diagnostic categories of The Bethesda System, with follow-up tissue sampling performed within 6 months of abnormal Pap test results to serve as the ground truth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The HGDDS demonstrated excellent performance in detecting significant Pap test findings, with close to 100% sensitivity (98.2%–100%) for cases classified as atypical squamous cells of undetermined significance and above within a 95% confidence interval and a high negative predictive value (92.4%–100%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The HGDDS streamlined workflow, reduced manual workload, and functioned as a stand-alone system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 7","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336058","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":"Untangling the mystery of rising breast cancer rates","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70026","DOIUrl":"https://doi.org/10.1002/cncy.70026","url":null,"abstract":"&lt;p&gt;After invasive breast cancer rates declined sharply in the early 2000s, clinicians cheered what seemed to be a major trend. The drop paralleled a big decline in the use of hormone replacement therapy among postmenopausal women after an influential study—the Women’s Health Initiative—found an association between estrogen–progesterone therapy and an increased risk of breast cancer and heart disease.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The overall incidence, however, soon leveled off and then began to rise again, with troubling increases over the decade ending in 2021, especially among women younger than 50 years and those of Asian American/Pacific Islander (AAPI) or Hispanic heritage. The highest relative increase, in fact, has occurred among women in their 20s and 30s. Researchers have launched investigations into a complex stew of mitigating and contributing factors—from increases in obesity and alcohol consumption to shifting reproductive patterns and earlier ages at first menstruation—but have yet to determine which are playing the biggest roles.&lt;/p&gt;&lt;p&gt;Although overall mortality rates continue to fall, they remain elevated for Native American and Alaska Native women in particular and for Black women. Changing that dynamic may require not only untangling the complex mix of molecular and environmental risk factors but also improving mammography methods and expanding access to medical care for underserved populations.&lt;/p&gt;&lt;p&gt;One of the biggest challenges has been understanding which factors are influencing breast cancer rates across the board and which are associated with particular risk groups. According to a 2024 report led by researchers at the American Cancer Society (ACS), the upswing in estrogen or progesterone receptor–positive (hormone receptor–positive) malignancies accounted for most of the recent increase in breast cancer incidence (the ACS publishes &lt;i&gt;Cancer Cytopathology&lt;/i&gt;).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The first author, Angela N. Giaquinto, MSPH, an associate scientist II in the ACS Surveillance Research Program, says that changing reproductive patterns have likely contributed to that upturn. “Having fewer children and/or having children later in life increases breast cancer risk by increasing lifetime exposure to estrogen, which is the driver for most breast cancers,” she explains. “However, pregnancy has a dual effect on breast cancer risk; risk is increased during pregnancy and in the first 5 years following childbirth and is only reduced after about 2 decades compared to those who have not given birth.”&lt;/p&gt;&lt;p&gt;That seemingly contradictory risk pattern may be mediated by changing hormone levels during and after pregnancy. Although the hormone levels likely play a role in the increased postpartum risk, Giaquinto says, “the biological mechanism is not fully understood.”&lt;/p&gt;&lt;p&gt;Adetunji T. Toriola, MD, PhD, MPH, a professor of surgery and a breast cancer researcher in the Division of Public Health Sciences at Washington University in","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 7","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144323564","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":"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}