Cancer Cytopathology最新文献

{"title":"Thyroid nodules and cancer: The search for certainty","authors":"Pamela Hartzband MD","doi":"10.1002/cncy.22882","DOIUrl":"10.1002/cncy.22882","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"738-740"},"PeriodicalIF":2.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603311","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 Milan system atypia of undetermined significance: 5-year performance data","authors":"Henri Lagerstam BMed,&nbsp;Erkka Tommola MD,&nbsp;Saara Kares MSc,&nbsp;Ivana Kholová MD, PhD, MIAC","doi":"10.1002/cncy.22883","DOIUrl":"10.1002/cncy.22883","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study was to evaluate the diagnostic performance of the category <i>atypia of undetermined significance</i> (AUS) at the authors' institution based on the Milan System for Reporting Salivary Gland Cytopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All AUS cases diagnosed at Fimlab Laboratories between January 1, 2018, and December 31, 2022, were included. Histologic verifications were checked until May 31, 2023. The upper-bound and lower-bound risk of malignancy and risk of neoplasm were calculated. The timelines between the pathology laboratory workflow and patient management were also calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1157 fine-needle aspirations (FNAs), 162 (14.0%) AUS cases were diagnosed in 146 patients, with an average ± standard deviation age of 66.1 ± 14.9 years. There was variation in the AUS percentages, with higher values during the coronavirus disease 2019 pandemic years (15% and 17.5% in 2020 and 2021, respectively). Seventy-five cases (46.3%) had histologic follow-up: 16 were malignant neoplasms, and 36 were benign neoplasms. The upper and the lower bounds of the-risk of malignancy and risk of neoplasm were 21.3% and 69.3% and 9.9% and 32.1%, respectively. The average time from the first FNA with an AUS diagnosis to surgical resection ranged from 6 to 682 days, and the time to the first repeat FNA ranged from 10 to 691 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results indicated higher percentages of AUS cases compared with the reference value, which may be attributed to the impact of the coronavirus disease 2019 pandemic. The risk of malignancy calculated in this study was closer to the reference value from the first edition of the Milan System for Reporting Salivary Gland Cytopathology compared with the second edition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 10","pages":"646-655"},"PeriodicalIF":2.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603310","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 artificial intelligence–enhanced digital urine cytology for bladder cancer diagnosis","authors":"Tien-Jen Liu,&nbsp;Wen-Chi Yang,&nbsp;Shin-Min Huang,&nbsp;Wei-Lei Yang,&nbsp;Hsing-Ju Wu,&nbsp;Hui Wen Ho,&nbsp;Shih-Wen Hsu,&nbsp;Cheng-Hung Yeh,&nbsp;Ming-Yu Lin,&nbsp;Yi-Ting Hwang,&nbsp;Pei-Yi Chu MD, PhD","doi":"10.1002/cncy.22884","DOIUrl":"10.1002/cncy.22884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study evaluated the diagnostic effectiveness of the AIxURO platform, an artificial intelligence–based tool, to support urine cytology for bladder cancer management, which typically requires experienced cytopathologists and substantial diagnosis time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One cytopathologist and two cytotechnologists reviewed 116 urine cytology slides and corresponding whole-slide images (WSIs) from urology patients. They used three diagnostic modalities: microscopy, WSI review, and AIxURO, per The Paris System for Reporting Urinary Cytology (TPS) criteria. Performance metrics, including TPS-guided and binary diagnosis, inter- and intraobserver agreement, and screening time, were compared across all methods and reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AIxURO improved diagnostic accuracy by increasing sensitivity (from 25.0%–30.6% to 63.9%), positive predictive value (PPV; from 21.6%–24.3% to 31.1%), and negative predictive value (NPV; from 91.3%–91.6% to 95.3%) for atypical urothelial cell (AUC) cases. For suspicious for high-grade urothelial carcinoma (SHGUC) cases, it improved sensitivity (from 15.2%–27.3% to 33.3%), PPV (from 31.3%–47.4% to 61.1%), and NPV (from 91.6%–92.7% to 93.3%). Binary diagnoses exhibited an improvement in sensitivity (from 77.8%–82.2% to 90.0%) and NPV (from 91.7%–93.4% to 95.8%). Interobserver agreement across all methods showed moderate consistency (κ = 0.57–0.61), with the cytopathologist demonstrating higher intraobserver agreement than the two cytotechnologists across the methods (κ = 0.75–0.88). AIxURO significantly reduced screening time by 52.3%–83.2% from microscopy and 43.6%–86.7% from WSI review across all reviewers. Screening-positive (AUC+) cases required more time than negative cases across all methods and reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AIxURO demonstrates the potential to improve both sensitivity and efficiency in bladder cancer diagnostics via urine cytology. Its integration into the cytopathological screening workflow could markedly decrease screening times, which would improve overall diagnostic processes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 11","pages":"686-695"},"PeriodicalIF":2.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603309","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 power and pitfalls of using social media to study rare cancers","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.22879","DOIUrl":"10.1002/cncy.22879","url":null,"abstract":"&lt;p&gt;Every year, roughly 1500–2000 women in the United States are diagnosed with a rare set of ovarian cancers known as granulosa cell tumors (GCTs), which carry a high risk of recurrence. Another 1300 individuals are diagnosed with adenoid cystic carcinomas (ACCs), which arise primarily in the salivary glands, commonly invade nerves, and metastasize to distant sites such as the lungs in approximately half of all cases.&lt;/p&gt;&lt;p&gt;Both cancers are rare enough that patients often struggled to connect with others facing the same malignancy until social media platforms such as Facebook helped them to connect through patient support groups. Such groups, in turn, have become critical resources for research efforts seeking to better understand the diseases and improve patient outcomes.&lt;/p&gt;&lt;p&gt;Amid the spate of recent warnings about the dangers of social media, including rampant misinformation, online groups have become the main vehicle for connecting patients and families affected by rare diseases. Physicians now regularly recommend Facebook groups to their patients, says Meghan Halley, PhD, MPH, a senior research scholar at the Stanford Center for Biomedical Ethics in Palo Alto, California. “It’s often the largest gathering of any patients with a particular very rare disease that’s available,” she says. “The extent to which the rare disease community has leveraged social media to identify other patients, share information, and provide social support is one of the few bastions of really good news in the social media space.”&lt;/p&gt;&lt;p&gt;Researchers have made good use of the space as well. In collaboration with the Granulosa Cell Tumor Survivor Sisters Facebook group, for example, a recent study based on an online survey of 743 patients revealed that 30% of respondents had recurrent disease, with one third of those recurrences occurring within 5 years of diagnosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The study represented one of the largest surveys yet of GCT patients’ treatment experiences. “Using naturally forming consumer groups may assist with developing the evidence base for care and supporting those living with GCT ovarian cancer,” the authors concluded.&lt;/p&gt;&lt;p&gt;Bioethicists such as Dr Halley, however, also have urged caution when relying on social media for bolstering research efforts. In a review of 120 social media–aided studies on rare noncancer diseases, she and her colleagues found that more than half relied exclusively on surveys, and the patient demographics, when reported, skewed toward female and White participants. “Despite its potential benefits in rare disease research, the use of social media is still methodologically limited, and the participants reached may not be representative of the rare disease population by gender, race, age, or rare disease type,” wrote the researchers.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Rare cancers are tracked, in part, through the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. Classification, thou","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 7","pages":"391-392"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466334","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":"Utility of an anchored multiplex polymerase chain reaction-based fusion assay for diagnosis of soft tissue tumors in cytology","authors":"T. Leif Helland MD,&nbsp;Adam S. Fisch MD, PhD,&nbsp;Ivan Chebib MD","doi":"10.1002/cncy.22881","DOIUrl":"10.1002/cncy.22881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fine-needle aspiration specimens from soft tissue tumors are complicated by lack of tissue architecture and limited material for ancillary testing. There are little data on the feasibility of next-generation sequencing techniques for fusion detection on soft tissue cytology specimens. This study explored the role of an anchored multiplex polymerase chain reaction (PCR)-based gene fusion assay in aiding the diagnosis of mesenchymal neoplasms on cytology samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The laboratory information system was queried for cytology specimens that had undergone testing by anchored multiplex PCR. After exclusion of epithelial and hematolymphoid neoplasms, clinical and pathologic information was collected on the remaining cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 1609 cytology specimens tested with anchored multiplex PCR. Of these, 48 (3%) were cytology specimens from mesenchymal tumors. Anchored multiplex PCR was positive for a reportable fusion transcript in 14 of 48 cases (29%); there was no fusion detected in 32 cases (67%), and there was insufficient tissue for analysis in two cases (4%). The detectable fusion partners included <i>ALK</i> (<i>n</i> = 4), <i>STAT6</i> (<i>n</i> = 4), <i>EWSR1</i> (<i>n</i> = 3), and one each of <i>SS18</i>, <i>YAP1</i>, and <i>PHF1</i>. Of the cases in which a fusion partner was detected, eight of 14 were disease-defining on cytology preparation, and six of 14 provided molecular confirmation of a metastatic focus of a previously diagnosed tumor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The anchored, multiplex PCR-based gene fusion assay is a powerful orthogonal tool in helping diagnose mesenchymal neoplasms on cytology specimens. The material obtained for cytologic analysis yields sufficient quality/quantity of tissue in the majority of cases tested.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"580-587"},"PeriodicalIF":2.6,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466333","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":"Risk of malignancy and overall survival associated with the diagnostic categories in the World Health Organization Reporting System for Pancreaticobiliary Cytopathology","authors":"Wen-Yu Hsiao MD, PhD,&nbsp;Qun Wang MD, PhD","doi":"10.1002/cncy.22880","DOIUrl":"10.1002/cncy.22880","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The World Health Organization (WHO) classification system revised the Papanicolaou Society of Cytopathology (PSC) system for reporting pancreaticobiliary cytopathology. To better stratify intraductal and/or cystic neoplasms by cytologic grade, the <i>neoplastic, other</i> category was replaced by two new categories: <i>pancreaticobiliary neoplasm, low-risk/grade</i> <i>(PaN-Low)</i> and <i>pancreaticobiliary neoplasm, high-risk/grade</i> <i>(PaN-High)</i>. Low-grade malignancies were placed in the <i>malignant</i> category, and benign neoplasms were placed in the <i>benign/negative for malignancy</i> category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An institutional pathology database search identified patients who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic lesions from January 2015 to April 2022. The absolute risk of malignancy (ROM) was determined by histologic and/or clinical follow-up of at least 6 months, and overall survival rates were calculated across diagnostic categories, comparing the WHO and PSC systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 1012 cases were reviewed and recategorized. The ROM for the WHO system was 8.3% for <i>insufficient/inadequate/nondiagnostic</i>, 3.2% for <i>benign/negative for malignancy</i>, 24.6% for <i>atypical</i>, 9.1% for <i>PaN-Low</i>, 46.7% for <i>PaN-High</i>, 75% for <i>suspicious for malignancy</i>, and 100% for <i>malignant</i>. Comparatively, the ROM for the PSC system was 7.4% for <i>nondiagnostic</i>, 3.0% for <i>negative for malignancy</i>, 23.1% for <i>atypical</i>, 0% for <i>neoplastic, benign</i>, 7.3% for <i>neoplastic, other</i>, 75% for <i>suspicious for malignancy</i>, and 100% for <i>malignant</i>. The WHO system demonstrated superior stratification for overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The WHO system significantly improves the stratification of ROM and overall survival across diagnostic categories by introducing the <i>PaN-Low</i> and <i>PaN-High</i> categories and reassigning low-grade malignancies to the <i>malignant</i> category. Analyzing EUS-FNA samples with the WHO system provides critical insights for guiding clinical management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 10","pages":"635-645"},"PeriodicalIF":2.6,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466332","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":"Rapid on-site evaluation of FNA biopsies and rapid interpretation of core biopsy touch preparation slides: Correct utilization of current procedural terminology codes","authors":"Swati Mehrotra MD,&nbsp;Carol A. Filomena MD","doi":"10.1002/cncy.22878","DOIUrl":"10.1002/cncy.22878","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 12","pages":"741-744"},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549355","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 negative outlook: Long-term follow up of ThyroSeq negative and low-risk nodules","authors":"Raquel A. Perry BS,&nbsp;Megan F. Lee MD,&nbsp;Rachel C. Jug MB, BCh, BAO,&nbsp;Rajesh C. Dash MD,&nbsp;Daniel J. Rocke MD, JD,&nbsp;Xiaoyin “Sara” Jiang MD","doi":"10.1002/cncy.22875","DOIUrl":"10.1002/cncy.22875","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Molecular testing of thyroid nodules is an essential tool to help risk stratify nodules with indeterminate cytology. Although ThyroSeq testing has been around for over a decade, there is a paucity of long-term follow-up data on cytologically indeterminate nodules that are determined to be molecularly negative or low-risk. The objective of this study is to assess the outcomes of nodules with indeterminate cytology (Bethesda III or IV) and negative or low-risk ThyroSeq results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single academic institution retrospective cohort study. Patients with at least one thyroid nodule sampled with fine-needle aspiration who underwent ThyroSeq testing from 2012 to 2018 and had negative or low-risk ThyroSeq results on a cytologically indeterminate sample (<i>n</i> = 159 patients, 167 nodules) were included in the study. Outcomes include the false-negative rate and negative predictive value of each test version, as well as follow-up length for each nodule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 159 patients with a mean age of 58 years (7–84 years) included in this study; the majority were female (81.8%). The mean follow-up was 4.0 years. Of 167 nodules, three were found to be malignant on resection (1.8%). The negative predictive value for the entire cohort was 98.2% and it was 89.3% for the surgical series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ThyroSeq testing has good negative predictive value and can help risk stratify cytologically indeterminate nodules. Routine follow-up allows for safe monitoring of nodules for features suggestive of malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 10","pages":"629-634"},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549354","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":"Genotype profile of HPV in ASC-H cytology and histologic follow-up—prevalence, distribution, and risk: A retrospective study of 1414 cases","authors":"Yihua Sun MD,&nbsp;Tiannan Wang MD, PhD,&nbsp;Fangfang Zhong MD,&nbsp;David Starr MD,&nbsp;Xianxu Zeng MD, PhD,&nbsp;Hao Zhang MD,&nbsp;Jianan Xiao MD,&nbsp;Xianrong Zhou MD,&nbsp;Xiang Tao MD, PhD,&nbsp;Chengquan Zhao MD","doi":"10.1002/cncy.22877","DOIUrl":"10.1002/cncy.22877","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A cytologic diagnosis of <i>atypical squamous cells, cannot exclude high-grade squamous lesion</i> (ASC-H) poses a disproportionately high risk of cervical cancer development. The objective of this study was to analyze type-specific risks by mapping human papillomavirus (HPV) genotypes in ASC-H cytology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 1,048,581 Papanicolaou tests that had ASC-H cytology were retrieved. Concurrent HPV genotyping using proprietary multiplex real-time (MRT) and polymerase chain reaction (PCR) HPV tests and histologic follow-up findings were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1678 patients who had ASC-H findings (0.16%), 1414 (84.3%) underwent concurrent HPV genotyping (MRT, 857; HPV PCR test, 557). The overall high-risk HPV (hrHPV)-positive rate was 84.4%. Of the 857 MRT cases, 63.9% were infected with a single hrHPV, and 24.4% had multiple genotypes. The most prevalent HPV types were HPV16/52/58/33/31. Lesions that were identified as cervical intraepithelial neoplasia 2 or worse (CIN2+) were detected in 498 of 906 cases (55.0%), including 81 cervical carcinomas (8.9%). The risk of CIN2+ for the composite group of HPV16/52/58/33/31-positive cases was 62.7%, representing 90.7% (264 of 291) of total CIN2+ lesions in ASC-H/hrHPV–positive cases by MRT. CIN2+ lesions were detected in 108 of 142 (76.1%) HPV16-positive and/or HPV18-positive women by the PCR the HPV test. Among 128 hrHPV-negative ASC-H cases by both methods, CIN2+ lesions were identified in 21 of 128 (16.4%), including five cervical carcinomas (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value for patients in the composite group with HPV16/52/58/33/31 were 88.0%, 40.8%, 62.7%, and 75.0%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Papanicolaou tests classified as ASC-H are associated with a high CIN2+ rate and warrant colposcopy, regardless of HPV status. The extent to which the risk-stratification provided by comprehensive HPV genotyping can inform the management of ASC-H cytology remains to be explored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"588-598"},"PeriodicalIF":2.6,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327260","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 features of differentiated high-grade thyroid carcinoma: A multi-institutional study of 40 cases","authors":"Vanda F. Torous MD,&nbsp;Tikamporn Jitpasutham,&nbsp;Zubair Baloch,&nbsp;Richard L. Cantley,&nbsp;Darcy A. Kerr,&nbsp;Xiaoying Liu,&nbsp;Zahra Maleki MD,&nbsp;Ross Merkin,&nbsp;Vania Nosé,&nbsp;Liron Pantanowitz,&nbsp;Isabella Tondi Resta,&nbsp;Esther D. Rossi MD, PhD,&nbsp;William C. Faquin","doi":"10.1002/cncy.22874","DOIUrl":"10.1002/cncy.22874","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Differentiated high-grade thyroid carcinoma (DHGTC) is recently recognized by the World Health Organization (WHO) as a subgroup of thyroid carcinomas with high-grade features while retaining the architectural and/or cytologic features of well-differentiated follicular–cell-derived tumors. The cytomorphology of DHGTC is not well documented despite potential implications for patient triage and management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The pathology archives of six institutions were searched for cases diagnosed on resection as “high-grade thyroid carcinoma” using WHO criteria. The fine-needle aspiration (FNA) cohort represents a 10-year period (2013–2023); all were reviewed to confirm DHGTC classification. The corresponding FNAs were assessed for 32 cytomorphologic features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty cases of DHGTC with prior FNA were identified. The mean patient age was 64.2 years. The average lesion size was 4.9 cm, and the majority demonstrated a TI-RADS score of 4 or 5 (95.2%). Three main high-grade subsets of DHGTC based on corresponding histology included papillary thyroid carcinoma (65%), follicular carcinoma (22.5%), and oncocytic carcinoma (12.5%). Over 97% of FNA cases were classified as Bethesda category IV or above. Approximately 25% of DHGTC showed cytologic features that included marked cytologic atypia, increased anisonucleosis, large oval nuclei, mitotic activity, or necrosis (<i>p</i> &lt; .05); 68% of DHGTC cases were associated with high-risk molecular alterations. <i>TERT</i> mutations occurred in 41%, of which 89% of these were associated with a second mutation, usually <i>RAS</i> or <i>BRAF p</i>.V600E.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cytology has a low sensitivity for DHGTC, although a subset of DHGTCs have cytologic features raising the possibility of a high-grade thyroid carcinoma. Other findings include high-risk molecular changes and clinicopathologic features such as older patient age and larger lesion size.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 8","pages":"525-536"},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316746","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}