Adam Kowalewski MD, PhD, MIAC, Jędrzej Borowczak MD, PhD, Olivier Choussy MD, Maria Lesnik MD, Nathalie Badois MD, Jerzy Klijanienko MD, PhD, MIAC
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Samples were classified according to the MSRSGC (nondiagnostic [ND], nonneoplastic [NN], atypia of undetermined significance [AUS], benign neoplasm [BN], salivary gland neoplasm of uncertain malignant potential [SUMP], suspicious for malignancy [SM], and malignant [M]) and the WHO system (insufficient/inadequate/nondiagnostic, benign, atypical, neoplasm of uncertain malignant potential [NUMP], suspicious for malignancy [SM], and malignant [M]). The risk of malignancy (ROM) was calculated for each category, and diagnostic performance metrics were assessed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the MSRSGC, the ROM was ND, 50% (<i>n</i> = 2); NN, 16.8% (<i>n</i> = 149); AUS (no cases); BN, 4.3% (<i>n</i> = 514); SUMP, 50% (<i>n</i> = 2); SM, 56.1% (<i>n</i> = 66); and M, 98.2% (<i>n</i> = 623). In the WHO system, the ROM was insufficient/inadequate/nondiagnostic, 50% (<i>n</i> = 2); benign, 7.1% (<i>n</i> = 663); atypical (no cases); NUMP, 50% (<i>n</i> = 2); SM, 56.1% (<i>n</i> = 66); and M, 98.2% (<i>n</i> = 623). The WHO’s “benign” category, which combines NN and BN, balanced the NN’s higher ROM (16.8%) and BN’s lower ROM (4.3%) into 7.1%. Excluding the ND and SUMP/NUMP categories, both systems demonstrated high diagnostic performance: sensitivity, 93.3%; specificity, 93.9%; positive predictive value, 94.2%; and negative predictive value, 92.9%.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Both systems effectively identify malignancy. The WHO system’s merger of NN and BN into the benign category streamlines reporting and reduces variability, although it may mask clinically significant differences between nonneoplastic and benign neoplastic lesions.</p>\n </section>\n </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70041","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of the World Health Organization Reporting System for Head and Neck Cytopathology and the Milan System for Reporting Salivary Gland Cytopathology\",\"authors\":\"Adam Kowalewski MD, PhD, MIAC, Jędrzej Borowczak MD, PhD, Olivier Choussy MD, Maria Lesnik MD, Nathalie Badois MD, Jerzy Klijanienko MD, PhD, MIAC\",\"doi\":\"10.1002/cncy.70041\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>A comparative analysis of the International Academy of Cytology–International Agency for Research on Cancer–World Health Organization Reporting System for Head and Neck Cytopathology (WHO) and the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was performed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 2218 salivary gland fine-needle aspiration samples collected at the Institut Curie, Paris (1954–2022) were evaluated, with 1356 having histological follow-up. Samples were classified according to the MSRSGC (nondiagnostic [ND], nonneoplastic [NN], atypia of undetermined significance [AUS], benign neoplasm [BN], salivary gland neoplasm of uncertain malignant potential [SUMP], suspicious for malignancy [SM], and malignant [M]) and the WHO system (insufficient/inadequate/nondiagnostic, benign, atypical, neoplasm of uncertain malignant potential [NUMP], suspicious for malignancy [SM], and malignant [M]). The risk of malignancy (ROM) was calculated for each category, and diagnostic performance metrics were assessed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>In the MSRSGC, the ROM was ND, 50% (<i>n</i> = 2); NN, 16.8% (<i>n</i> = 149); AUS (no cases); BN, 4.3% (<i>n</i> = 514); SUMP, 50% (<i>n</i> = 2); SM, 56.1% (<i>n</i> = 66); and M, 98.2% (<i>n</i> = 623). In the WHO system, the ROM was insufficient/inadequate/nondiagnostic, 50% (<i>n</i> = 2); benign, 7.1% (<i>n</i> = 663); atypical (no cases); NUMP, 50% (<i>n</i> = 2); SM, 56.1% (<i>n</i> = 66); and M, 98.2% (<i>n</i> = 623). The WHO’s “benign” category, which combines NN and BN, balanced the NN’s higher ROM (16.8%) and BN’s lower ROM (4.3%) into 7.1%. Excluding the ND and SUMP/NUMP categories, both systems demonstrated high diagnostic performance: sensitivity, 93.3%; specificity, 93.9%; positive predictive value, 94.2%; and negative predictive value, 92.9%.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Both systems effectively identify malignancy. The WHO system’s merger of NN and BN into the benign category streamlines reporting and reduces variability, although it may mask clinically significant differences between nonneoplastic and benign neoplastic lesions.</p>\\n </section>\\n </div>\",\"PeriodicalId\":9410,\"journal\":{\"name\":\"Cancer Cytopathology\",\"volume\":\"133 9\",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70041\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Cytopathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncy.70041\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncy.70041","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Comparative analysis of the World Health Organization Reporting System for Head and Neck Cytopathology and the Milan System for Reporting Salivary Gland Cytopathology
Background
A comparative analysis of the International Academy of Cytology–International Agency for Research on Cancer–World Health Organization Reporting System for Head and Neck Cytopathology (WHO) and the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was performed.
Methods
A total of 2218 salivary gland fine-needle aspiration samples collected at the Institut Curie, Paris (1954–2022) were evaluated, with 1356 having histological follow-up. Samples were classified according to the MSRSGC (nondiagnostic [ND], nonneoplastic [NN], atypia of undetermined significance [AUS], benign neoplasm [BN], salivary gland neoplasm of uncertain malignant potential [SUMP], suspicious for malignancy [SM], and malignant [M]) and the WHO system (insufficient/inadequate/nondiagnostic, benign, atypical, neoplasm of uncertain malignant potential [NUMP], suspicious for malignancy [SM], and malignant [M]). The risk of malignancy (ROM) was calculated for each category, and diagnostic performance metrics were assessed.
Results
In the MSRSGC, the ROM was ND, 50% (n = 2); NN, 16.8% (n = 149); AUS (no cases); BN, 4.3% (n = 514); SUMP, 50% (n = 2); SM, 56.1% (n = 66); and M, 98.2% (n = 623). In the WHO system, the ROM was insufficient/inadequate/nondiagnostic, 50% (n = 2); benign, 7.1% (n = 663); atypical (no cases); NUMP, 50% (n = 2); SM, 56.1% (n = 66); and M, 98.2% (n = 623). The WHO’s “benign” category, which combines NN and BN, balanced the NN’s higher ROM (16.8%) and BN’s lower ROM (4.3%) into 7.1%. Excluding the ND and SUMP/NUMP categories, both systems demonstrated high diagnostic performance: sensitivity, 93.3%; specificity, 93.9%; positive predictive value, 94.2%; and negative predictive value, 92.9%.
Conclusions
Both systems effectively identify malignancy. The WHO system’s merger of NN and BN into the benign category streamlines reporting and reduces variability, although it may mask clinically significant differences between nonneoplastic and benign neoplastic lesions.
期刊介绍：
Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.
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