Cancer Cytopathology最新文献

{"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":"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":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70024","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":"OA","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":"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":3.2,"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":"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":3.2,"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":"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":3.2,"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":"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":3.2,"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}

{"title":"Cytopathology of follicular and oncocytic follicular thyroid neoplasms: A Bethesda System perspective","authors":"André Lametti MD,&nbsp;Fadi Brimo MD,&nbsp;Yonca Kanber MD,&nbsp;Derin Caglar MD,&nbsp;Manon Auger MD","doi":"10.1002/cncy.70016","DOIUrl":"10.1002/cncy.70016","url":null,"abstract":"<p>The third edition of The Bethesda System for Reporting Thyroid Cytopathology includes category IV, follicular neoplasm (FN), which is used to classify fine-needle aspirates of thyroid nodules that may correspond to invasive follicular-derived neoplasia other than papillary thyroid carcinoma. This diagnosis is infrequently rendered, and may represent a challenge for pathologists. This review presents a practical approach to FN and its subtype oncocytic follicular neoplasm (OFN). First, minimal criteria for the diagnosis must be achieved, namely sufficient cellularity, architectural features consistent with neoplasia, and follicular cell or oncocytic cytomorphology. Second, select diagnoses that are common or important differential diagnoses for FN or OFN must be ruled out, via a combination of morphological findings and limited ancillary tests, when available. These include follicular nodular disease, parathyroid sampling, metastatic carcinoma, noninvasive follicular thyroid neoplasm with papillary-like nuclear features, medullary thyroid carcinoma, certain subtypes of papillary thyroid carcinoma, and lymphocytic thyroiditis. This approach should allow for a careful selection of cases where diagnostic thyroid lobectomy is an appropriate therapeutic modality.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865829","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":"Cytology of cystic lesions of the pancreas: Practical insights, pearls, and pitfalls","authors":"M. Lisa Zhang MD,&nbsp;Martha B. Pitman MD","doi":"10.1002/cncy.70011","DOIUrl":"10.1002/cncy.70011","url":null,"abstract":"<p>Pancreatic cyst fluid (PCF) specimens present significant interpretive challenges. Accurate preoperative diagnosis is essential for guiding patient management, as pancreatic cysts vary from benign to pre-malignant and malignant. Appropriate triage differentiates low-risk cysts requiring surveillance from high-risk cysts necessitating surgical resection, the latter of which have increased likelihood of progressing to or harboring invasive carcinoma. Optimal PCF assessment integrates radiological, cytological, biochemical, and molecular findings if available. Key biochemical markers such as carcinoembryonic antigen and glucose can improve the detection of neoplastic mucinous cysts. However, cytology remains the most specific modality for identifying high-risk cysts. Cytomorphologic interpretation is particularly challenging due to the scant cellularity and degenerative changes often present in these specimens. This review provides practical insights to improve the evaluation of pancreatic cysts, emphasizing the importance of a multidisciplinary approach and highlighting diagnostic pearls and common pitfalls to aid in accurate interpretation and optimal patient care.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846196","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":"Introducing Cancer Cytopathology Practice Essentials: A new series of practical and up-to-date reviews","authors":"Michiya Nishino MD, PhD,&nbsp;Mauro Saieg MD, PhD, FIAC","doi":"10.1002/cncy.70010","DOIUrl":"10.1002/cncy.70010","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846197","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":"Cytology-Radiology Correlation Series: Pancreatic cytopathology","authors":"Judy Trieu MD,&nbsp;Andrew Gilman MD,&nbsp;Katerina Konstantinoff MD,&nbsp;Maria D. Lozano MD,&nbsp;Mauro Saieg MD, PhD","doi":"10.1002/cncy.70012","DOIUrl":"10.1002/cncy.70012","url":null,"abstract":"<p>The prevalence of pancreatic lesions has increased over the years because of an increase in accessibility to and the quality of cross-sectional imaging. This commentary describes the common non-neoplastic and neoplastic pancreatic lesions. The images in this commentary depict classic cross-sectional images, sonographic findings, and the cytopathologic diagnosis of each lesion. Most common non-neoplastic lesions include pseudocysts, autoimmune pancreatitis, and chronic pancreatitis. Most common neoplastic lesions include serous cystadenomas, intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, solid pseudopapillary neoplasms, neuroendocrine tumors, pancreatic ductal adenocarcinoma, acinar cell carcinoma, and metastases to the pancreas. The aim of this Cytoimaging Correlation Series is to demonstrate the multidisciplinary involvement in the diagnosis of pancreatic pathology and to highlight main findings in the most common entities found in everyday practice.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836168","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":"Clinicopathological and molecular characterization of non–small cell lung cancer with pericardial effusions","authors":"Weijie Ma MD,&nbsp;Nathalie J. Rodrigues Simoes MD,&nbsp;Peter P. Seery,&nbsp;Tianhong Li MD, PhD,&nbsp;Laura J. Tafe MD,&nbsp;Darcy A. Kerr MD,&nbsp;Xiaoying Liu MD","doi":"10.1002/cncy.70015","DOIUrl":"10.1002/cncy.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cytological evaluation is essential for assessing pericardial effusions (PEs) in non–small cell lung cancer (NSCLC). This study retrospectively examined the clinicopathological, molecular, and prognostic characteristics of patients with NSCLC with PE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 80 patients with NSCLC with PE treated at an academic center over the course of 15 years were reviewed. PE specimens were categorized according to the International System for Reporting Serous Fluid Cytopathology (ISRSFC). The analysis included patient demographics, molecular alterations, cytopathology, histology, and survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 80 patients, 36 (45%) were female and 90% had stage IV disease. A smoking history was noted in 58 patients (72.5%), and 22 patients (27.5%) presented with tamponade. Lung adenocarcinoma predominated (87.5%). The ISRSFC categorized 25% of the specimens as negative for malignancy (NFM), 7.5% as atypia of undetermined significance (AUS), 3.75% as suspicious for malignancy (SFM), and 63.75% as malignant (MAL). Immunohistochemistry in 57 specimens identified thyroid transcription factor 1 (65%) as the most frequently positive marker. Molecular analysis revealed <i>p53</i> mutations (59.1%) as the most prevalent, followed by <i>KRAS</i> (34.1%) and <i>EGFR</i> (15.9%). Kaplan–Meier analysis showed significantly better survival for NFM patients than non-NFM patients (MAL, SFM, and AUS; <i>p</i> = .0036). Bloody PEs and tamponade were associated with worse outcomes. The immunotherapy group achieved the most prolonged survival among stage IV patients (9.07 months; <i>p</i> = .017). Cox regression confirmed cytology-negative status as an independent prognostic factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cytological evaluation and ISRSFC classification are crucial for NSCLC-associated PEs. A multidisciplinary approach integrating cytology, immunohistochemistry, and molecular profiling is essential for optimal management and prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831193","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}