Cancer Cytopathology最新文献

{"title":"Increasing trainee engagement and laboratory feedback during an internal laboratory inspection","authors":"Marlo Dilks MHA, Allison Goldberg MD","doi":"10.1002/cncy.22906","DOIUrl":"10.1002/cncy.22906","url":null,"abstract":"<p>The inadequacy of laboratory management training has long been reported in the literature,<span><sup>1-4</sup></span> with various suggestions on ways to improve this aspect of pathology education and better prepare our trainees for the work of a staff pathologist.<span><sup>5-8</sup></span> The ACGME (Accreditation Council for Graduate Medical Education) milestones directly reflect this educational need and include a requirement of participation in an internal or external laboratory inspection to reach level four, the goal level for graduation, in the residency milestone <i>Systems-based practice 5: Accreditation, compliance, and quality (AP/CP)</i>. There are similar requirements for many of the pathology fellowships, including <i>Systems-based practice 4: Accreditation, compliance, and quality</i> for blood banking/transfusion medicine, chemical pathology, cytopathology, dermatopathology, forensic pathology, hematopathology, medical microbiology, neuropathology, and pediatric pathology and <i>Systems-based practice 5: Accreditation, compliance, and quality</i> in molecular genetic pathology<span><sup>9</sup></span> (for a description of milestones by level, seeTable 1). Furthermore, such participation has long been part of <i>laboratory management</i> curricula.<span><sup>8</sup></span></p><p>The literature provides a few specific examples of departmental efforts toward using an internal inspection to support trainee advancement to level four of the <i>accreditation, compliance, and quality</i> milestone. In one report from the University of Florida, the trainees made up the entire inspection team, with the associate program director serving as the team leader. Four lunchtime seminars covering a range of laboratory management topics were provided, and preinspection and postinspection assessments were performed, showing a significant improvement in trainees' knowledge after the inspection.<span><sup>10</sup></span> Another report from the University of California Irvine Medical Center describes a resident-led self-inspection of the department's histology laboratory and the subsequent decrease in deficiencies and improvement in staff satisfaction survey results for that laboratory.<span><sup>11</sup></span> Finally, a group out of Emory University created a clinical laboratory management curriculum that included preparation for and performance of an out-of-cycle mock inspection in one of the areas of the laboratory.<span><sup>12</sup></span> Those authors report that the curriculum was well received and provided objective measurements of mastery for a range of laboratory medicine concepts. Some subspecialties within pathology have created subspecialty-specific laboratory management education options as well.<span><sup>13</sup></span></p><p>At our institution, we have long included residents and fellows in external inspections when possible and based on specific laboratory management interests and in our internal laboratory inspection in at le","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227083","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":"Cytologic diagnosis of papillary renal neoplasm with reverse polarity","authors":"Sarah J. Wu MD, PhD,&nbsp;Andrew A. Renshaw MD,&nbsp;Peter M. Sadow MD, PhD,&nbsp;Navin R. Mahadevan MD, PhD,&nbsp;Michelle S. Hirsch MD, PhD,&nbsp;Murugesan Manoharan MD,&nbsp;Edmund S. Cibas MD","doi":"10.1002/cncy.22903","DOIUrl":"10.1002/cncy.22903","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Papillary renal neoplasm with reverse polarity is a recently recognized low-grade neoplasm with a favorable prognosis. To date, its cytologic features have not been well documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two patients with papillary renal neoplasm with reverse polarity sampled by fine needle aspiration and core needle biopsy are described, one of whom is under active surveillance without clinical progression and the other is alive and well 16 years after partial nephrectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cytologic features included a mix of papillae and dispersed cells with abundant oncocytic cytoplasm and round, bland nuclei apically displaced away from the papillary core. Immunohistochemistry showed positive staining for GATA3 in both cases. Molecular studies on one of the cases showed a <i>KRAS</i> p.G12V mutation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The cytologic features of this distinctive, indolent neoplasm are important to recognize because patients with papillary renal neoplasm with reverse polarity may be excellent candidates for partial nephrectomy or even active surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217990","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":"Retrieving new clues about a dog breed’s “insane” cancer risk","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.22899","DOIUrl":"https://doi.org/10.1002/cncy.22899","url":null,"abstract":"&lt;p&gt;Golden retrievers, consistently among the most popular dog breeds in the United States, are known as playful and family-friendly companions that are eager to please. A large longitudinal study, now in its 12th year, has revealed an additional, devastating trait: three of every four documented retriever deaths so far have been linked to cancer—by far the highest rate for any breed and among the highest rates of any animal. Of those cancer deaths, 70% are due to hemangiosarcoma, an aggressive blood vessel malignancy that is almost always fatal except for an uncommon cutaneous subtype.&lt;/p&gt;&lt;p&gt;If cuddlier than the unusually cancer-resistant rodents known as naked mole-rats, golden retrievers are at the opposite end of the susceptibility spectrum, making them another focal point of research. Teasing out cancer-associated factors, researchers say, could help to improve the beloved dogs’ longevity—as well as our own.&lt;/p&gt;&lt;p&gt;The Denver-based Morris Animal Foundation launched the biggest research effort to date, the Golden Retriever Lifetime Study, in 2012.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Veterinary researchers there enrolled 3044 privately owned dogs throughout the United States (all between 6 months and 2 years of age) to investigate not only the incidence but also environmental and genetic risk factors for cancers and other diseases, such as cognitive decline and osteoarthritis. With the oldest participants now turning 14 years old, Julia Labadie, DVM, PhD, MSPH, the study’s principal investigator, says that studying aging in dogs has emerged as an unanticipated additional goal.&lt;/p&gt;&lt;p&gt;“We have now a cohort of pretty old golden retrievers,” she says, noting that a significant fraction of those survivors could die of non-cancer causes. “So I think there’s a lot of questions that we can answer about the dogs that don’t get cancer and the dogs that live longer than the normal lifespan for golden retrievers that we always quote of about 10 to 12 years.”&lt;/p&gt;&lt;p&gt;Another recent study already is hinting that at least part of the longevity difference may be linked to variants in a gene encoding an epidermal growth factor receptor. Led by Robert Rebhun, DVM, PhD, chair of medical oncology at the University of California Davis School of Veterinary Medicine, the researchers discovered that a variant in a noncoding region of the &lt;i&gt;ERBB4&lt;/i&gt; gene (also known as &lt;i&gt;HER4&lt;/i&gt;) grants golden retrievers an extra 2 years of life on average.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Interestingly, &lt;i&gt;ERBB4&lt;/i&gt; appears to have a “good variant” that is associated with longer lifespans and a “bad variant” that is associated with shorter lifespans.&lt;/p&gt;&lt;p&gt;Because longevity in the breed is highly influenced by cancer, the genetic variants are almost certainly associated with cancer as well, says coauthor Michael Kent, DVM, MS, a professor of radiation oncology at the veterinary school. Other research has found that &lt;i&gt;ERBB4&lt;/i&gt; can serve as both a tumor suppressor and an oncogene.&lt;/p&gt;&lt;p&gt;“Everyone thoug","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"541-542"},"PeriodicalIF":2.6,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142165279","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 performance of fine-needle aspiration in soft tissue tumors: Application of the World Health Organization System for Reporting Soft Tissue Cytopathology and risk of malignancy assessment","authors":"Pawel Gajdzis MD, PhD,&nbsp;Hervé J. Brisse MD, PhD,&nbsp;Jerzy Klijanienko MD, PhD, MIAC","doi":"10.1002/cncy.22897","DOIUrl":"10.1002/cncy.22897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recently, a new World Health Organization Reporting System for Soft Tissue Cytopathology (WHO System) was introduced. To analyze the value of this system, routine fine-needle aspiration soft tissue tumor (STT) cases were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cytology samples of STTs collected between 1954 and 2022 at the Institut Curie were used (2214 cases, including 1376 primary tumors). All specimens were classified according to the predominant cytomorphological pattern and the WHO System. The diagnostic accuracy and risk of malignancy (ROM) in each category were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Final diagnoses revealed 1236 malignancies and 978 benign or low-risk tumors. The original cytological evaluation led to 21 false-negative results (0.85%) and 29 false-positive results (1.17%). Sensitivity, specificity, positive predictive value, and negative predictive value were 98.3%, 92.1%, 97.5%, and 94.2%, respectively. Overall diagnostic accuracy was 94.2%. The ROM calculated according to the WHO System was 29.87%, 2.49%, 39.62%, 51.43%, 68.42%, and 97.69% in the nondiagnostic, benign, atypical, soft tissue neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant categories, respectively; however, it varied broadly depending on the morphological pattern (62.78% in spindle cell tumors, 84.58% in myxoid tumors, 3.00% in lipomatous tumors, 78.15% in epithelioid tumors, 94.26% in pleomorphic tumors, and 100% in round cell tumors).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cytology of STTs is a powerful diagnostic method. Some cytological patterns overlap in different morphological groups, and the possibility of false-negative and false-positive diagnoses may persist. This analysis evidenced utility of the WHO System, especially when combined with morphological pattern assessment. Subclassification in particular diagnostic categories allowed for calculation of the ROM, which is crucial for optimal patient management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"768-778"},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104580","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":"Comparative genomic and immunopathologic analysis of lung adenocarcinomas with and without cytology-proven malignant pleural effusions","authors":"Cristiana M. Pineda MD, PhD,&nbsp;Adnan Majid MD,&nbsp;Daniel B. Costa MD, PhD,&nbsp;Paul A. VanderLaan MD, PhD","doi":"10.1002/cncy.22900","DOIUrl":"10.1002/cncy.22900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer complicated by malignant pleural effusions (MPEs) is associated with significantly increased morbidity and mortality, yet the mechanisms of MPE development remain poorly understood. This study sought to elucidate whether there were specific genomic alterations and/or immunologic biomarkers associated with the presence of MPEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis of comprehensive genomic and immunologic profiling for 275 locally advanced (stage III) or advanced (stage IV) lung adenocarcinomas was subcategorized into cytology-confirmed MPE-positive (MPE+; <i>n</i> = 139 stage IV) and MPE-negative (MPE−; <i>n</i> = 30 stage III + <i>n</i> = 106 stage IV) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Smoking frequency (<i>p</i> = .0001) and tumor mutational burden (<i>p</i> &lt; .001) were demonstrated to be lower in the MPE+ group compared to the MPE− group. Median overall survival in the MPE+ group was shorter than in the MPE− group across all data (2.0 vs. 5.5 years; <i>p</i> &lt; .0001) and for smokers (1.2 vs. 6.4 years; <i>p</i> &lt; .0001). There were a number of differences at the genomic level across all cases and when stratifying by smoking status, including a higher frequency of <i>EGFR</i> mutations and a lower frequency of <i>STK11</i> mutations in the MPE+ cohort. Finally, investigation of the comutational profiles of tumors by MPE status revealed differences in <i>TP53</i>- and <i>STK11</i>-mutant tumors between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, these findings imply that there are both clinical and genetic factors associated with advanced lung adenocarcinoma MPEs. Future studies of these alterations may prove important both for understanding the pathophysiology of MPE development in advanced cancer and for the earlier detection of at-risk patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"788-798"},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104579","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":"Utilization of an artificial intelligence–enhanced, web-based application to review bile duct brushing cytologic specimens: A pilot study","authors":"Neil B. Marya MD,&nbsp;Patrick D. Powers,&nbsp;Melanie C. Bois MD,&nbsp;Christopher Hartley MD,&nbsp;Sarah E. Kerr MD,&nbsp;Judith Jebastin Thangaiah MBBS, MD,&nbsp;Daniel Norton BA,&nbsp;Barham K. Abu Dayyeh MD, MPH,&nbsp;Richard Cantley MD,&nbsp;Vinay Chandrasekhara MD,&nbsp;Gregory Gores MD,&nbsp;Ferga C. Gleeson MB, BCh,&nbsp;Ryan J. Law DO,&nbsp;Zahra Maleki MD,&nbsp;John A. Martin MD,&nbsp;Liron Pantanowitz MB, BCh,&nbsp;Bret Petersen MD,&nbsp;Andrew C. Storm MD,&nbsp;Michael J. Levy MD,&nbsp;Rondell P. Graham MBBS","doi":"10.1002/cncy.22898","DOIUrl":"10.1002/cncy.22898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The authors previously developed an artificial intelligence (AI) to assist cytologists in the evaluation of digital whole-slide images (WSIs) generated from bile duct brushing specimens. The aim of this trial was to assess the efficiency and accuracy of cytologists using a novel application with this AI tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive bile duct brushing WSIs from indeterminate strictures were obtained. A multidisciplinary panel reviewed all relevant information and provided a central interpretation for each WSI as being “positive,” “negative,” or “indeterminate.” The WSIs were then uploaded to the AI application. The AI scored each WSI as positive or negative for malignancy (i.e., computer-aided diagnosis [CADx]). For each WSI, the AI prioritized cytologic tiles by the likelihood that malignant material was present in the tile. Via the AI, blinded cytologists reviewed all WSIs and provided interpretations (i.e., computer-aided detection [CADe]). The diagnostic accuracies of the WSI evaluation via CADx, CADe, and the original clinical cytologic interpretation (official cytologic interpretation [OCI]) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 84 WSIs, 15 were positive, 42 were negative, and 27 were indeterminate after central review. The WSIs generated on average 141,950 tiles each. Cytologists using the AI evaluated 10.5 tiles per WSI before making an interpretation. Additionally, cytologists required an average of 84.1 s of total WSI evaluation. WSI interpretation accuracies for CADx (0.754; 95% CI, 0.622–0.859), CADe (0.807; 95% CI, 0.750–0.856), and OCI (0.807; 95% CI, 0.671–0.900) were similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This trial demonstrates that an AI application allows cytologists to perform a triaged review of WSIs while maintaining accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"779-787"},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104581","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":"AICyte-alone capabilities as an independent screener for triaging cervical cytology using a 50% negative cutoff value","authors":"Xianxu Zeng MD, PhD,&nbsp;David Starr MD,&nbsp;Juan Li MD,&nbsp;Xuejie Bi MD,&nbsp;Chun Wang MD,&nbsp;Xinru Bai MD,&nbsp;Yanxue Yin MD,&nbsp;Xue Wu MD,&nbsp;Jingjing Wei MD,&nbsp;Hui Du MD, PhD,&nbsp;Wenkui Dai PhD,&nbsp;Changzhong Li MS,&nbsp;Xiangchen Wu PhD,&nbsp;Ruifang Wu MD,&nbsp;Chengquan Zhao MD","doi":"10.1002/cncy.22896","DOIUrl":"10.1002/cncy.22896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>AICyte has previously demonstrated a potential role in cervical cytology screening for reducing the workload by using a 50% negative cutoff value. The aim of the current study is to evaluate this hypothesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors used the Ruiqian WSI-2400 (with the registered trademark AICyte) to evaluate a collection of 163,848 original cervical cytology cases from 2018 to 2023 that were collected from four different hospital systems in China. A breakdown of cases included 46,060 from Shenzhen, 67,472 from Zhengzhou, 25,667 from Shijiazhuang, and 24,649 from Jinan. These collected cases were evaluated using the AICyte system, and the data collected were statistically compared with the original interpretative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 98.80% of all artificial intelligence cases that were designated as not needing further review, the corresponding original diagnosis was also determined to be negative. For any cases that were designated atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion or higher, the sensitivity and negative predictive value were 90.77% and 98.80%, respectively. The sensitivity and negative predictive value were greater in cases designated as low-grade squamous intraepithelial lesion or higher at 98.92% and 99.94%, respectively. Of the 49 low-grade squamous intraepithelial lesion or higher that were designed by AICyte as not needing further review, the cytohistologic correlation revealed eight cases of cervical intraepithelial neoplasia 1 and 18 negative cases; and the remaining cases were without histologic follow-up. In practice, AICyte used at a 50% negative cutoff value could reduce the anticipated workload if a protocol were implemented to label cases that qualified within the negative cutoff value as not needing further review, thereby finalizing the case as negative for intraepithelial lesions and malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For pathologic practices that do not have cytotechnologists or in which the workflow is sought to be optimized, the artificial intelligence system AICyte alone to be an independent screening tool by using a 50% negative cutoff value, which is a potential assistive method for cervical cancer screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 11","pages":"723-730"},"PeriodicalIF":2.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999429","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":"RNA extended interventional nucleic acid longitudinal study: Clinical performance of Aptima messenger RNA HPV testing in cervical cancer screening with a 9-year follow-up","authors":"Rosario Granados MD, PhD, FIAC,&nbsp;Joanny A. Duarte MD,&nbsp;David R. Luján MD,&nbsp;Ana M. Gutierrez-Pecharromán MD, FIAC,&nbsp;Isabel Solís MD,&nbsp;Lourdes Molpeceres MD,&nbsp;Paloma Bajo CT,&nbsp;Elsa Palencia RN,&nbsp;Nuria Martín RN","doi":"10.1002/cncy.22895","DOIUrl":"10.1002/cncy.22895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a need for additional longitudinal studies with the Aptima messenger RNA human papillomavirus test (AHPV) to support the safety of extended screening intervals. RNA-based extended interventional nucleic acid (REINA) provides relevant information on the clinical performance of AHPV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a longitudinal prospective analysis of 1538 participants after AHPV and liquid-based cytology (LBC) co-test complemented with REINA interventional protocol with a second co-test 4 years after negative screening on 2000 women. Diagnostic accuracy and cumulative risks for CIN2+ up to 9 years were calculated for all test combinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity and specificity for CIN2+ were 96.9% and 88.0% for AHPV and 72.3% and 92.0% for LBC. Negative predictive value (NPV) and positive predictive value (PPV) of AHPV were 99.9% and 23.6%. The 5- and 9-year risks of AHPV-negative women were 0.4% and 1.0% (CIN2+) and 0.3% and 0.7% (CIN3+), a 73% and 64% lower risk than with negative LBC (<i>p</i> ≤ .002). REINA participants with an AHPV-positive result at second co-test after a negative AHPV in first round had a significantly lower 5-year risk of CIN2+ (11.1%) than AHPV-positive women with unknown HPV history (29.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Currently, this constitutes the longest European longitudinal study with AHPV testing in screening population. It reveals 99.9% NPV and a significant protective effect of a previous negative test 5 years after a new HPV infection. These findings support the safety of Aptima for screening intervals beyond 5 years. The risk of disease is lower 9 years after a negative AHPV test than 3 years after a negative LBC. High specificity and PPV of Aptima may benefit controlling overtreatment and colposcopy referrals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"757-767"},"PeriodicalIF":2.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999430","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 Sydney system for lymph node FNA biopsy cytopathology: A detailed analysis of recent publications and meta-analysis and a proposal for the components of an ideal prospective study of a cytopathology reporting system","authors":"Sharron Liang MB, BS, FRCPA,&nbsp;Immacolata Cozzolino MD,&nbsp;Pio Zeppa MD,&nbsp;Andrew S. Field MB, BS(Hons), FRCPA, FIAC","doi":"10.1002/cncy.22890","DOIUrl":"10.1002/cncy.22890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Sydney system for fine-needle aspiration biopsy of lymph nodes has five categories, stressing the role of correlation of cytopathology with clinical, ultrasound, and ancillary findings to achieve diagnosis. The five categories constitute a hierarchical system with increasing risk of malignancy from benign to atypical, suspicious, and malignant categories, which informs recommendations for further workup to achieve a final diagnosis as possible. This article analyzes 10 publications using the Sydney system and a meta-analysis of nine of these studies. The primary goal of the analysis is to ascertain the causes of the large ranges in risk of malignancy for the “atypical” and “inadequate” compared to “benign,” “suspicious,” and “malignant” categories, which were comparable to well-established reporting systems. Research protocols are proposed to improve future studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed literature search from January 2021 to December 2023 identified studies evaluating performance of the Sydney system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten studies showed heterogeneity with clinical setting, study design, ultrasound use and rapid on-site evaluation, operator, cutoff points for “positive” cases, with inherent partial verification biases, resulting in a wide range of risk of malignancy, specificity, and sensitivity values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Analysis shows the large range is due to heterogeneity of the studies, which suffer from biases and variable statistical analysis that are ultimately included in any meta-analysis, detracting from the usefulness of the risk of malignancy derived by the meta-analysis. Components for ideal analyses of reporting systems are presented.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"745-756"},"PeriodicalIF":2.6,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888498","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 utility of next-generation sequencing in challenging liver FNA biopsies","authors":"Dana J. Balitzer MD,&nbsp;Nancy Y. Greenland MD, PhD","doi":"10.1002/cncy.22893","DOIUrl":"10.1002/cncy.22893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fine-needle aspiration (FNA) biopsy is increasingly used for the diagnosis of hepatocellular masses. Because distinguishing well differentiated hepatocellular carcinoma (HCC) from other well differentiated hepatocellular lesions (e.g., large regenerative nodules or focal nodular hyperplasia) requires an assessment of architectural features, this may be challenging on FNA when intact tissue fragments are not sampled. Poorly differentiated HCC and intrahepatic cholangiocarcinoma (ICC) may exhibit overlapping pathologic features. Molecular testing can be helpful, because mutations in <i>TERT</i> promoter and <i>CTNNB1</i> (β-catenin) are characteristic of HCC, whereas mutations in <i>BAP1</i>, <i>IDH1/IDH2</i>, and <i>PBRM1</i> may favor ICC. The goal of this study was to assess the role of next-generation sequencing (NGS) in further subclassifying indeterminate liver lesions sampled by FNA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of liver cytology cases with NGS on cell block material was performed. Age, radiologic features, background hepatic disease and treatment, outcome, and NGS data were obtained from the electronic medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve FNA biopsies that had cell blocks from clinically suspected primary hepatic masses were identified. The presence of a <i>TERT</i> promoter mutation supported a diagnosis of HCC for one well differentiated neoplasm. For three patients, the presence of mutations, such as <i>IDH1</i>, <i>CDKN2A/CDKN2B</i>, and <i>BRAF</i>, supported a diagnosis of ICC. Of the eight poorly differentiated carcinomas, NGS helped refine the diagnosis in six of eight cases, with one HCC, three ICCs, and two that had combined HCC-ICC, with two cases remaining unclassified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Molecular diagnostics can be helpful to distinguish HCC and ICC on FNA specimens, although a subset of primary hepatic tumors may remain unclassifiable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 11","pages":"714-722"},"PeriodicalIF":2.6,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888499","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}