Comparison of risk of malignancy and predictive value of diagnostic categories defined by Papanicolaou Society of Cytopathology system and WHO reporting system for pancreaticobiliary cytopathology in solid pancreatic lesions.

IF 3.9 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Therapeutic Advances in Gastroenterology Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.1177/17562848241271958

Béla Vasas, Anna Fábián, Zsófia Bősze, Sándor Hamar, László Kaizer, Tibor Tóth, Péter Bacsur, Tamás Resál, Anita Bálint, Klaudia Farkas, Tamás Molnár, Zoltán Szepes, Renáta Bor

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Abstract

Background: The standardized diagnostic categories defined by the World Health Organization (WHO) reporting system support the interdisciplinary interpretation of cytological findings in the management of pancreatic cancer.

Objective: To compare this classification to the Papanicolaou Society of Cytopathology (PSC) system in terms of predictive value and risk of malignancy (ROM) in solid pancreatic lesions.

Design: Retrospective cohort study.

Methods: All consecutive patients with solid pancreatic lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) sampling at the University of Szeged from 2014 to 2021 were retrospectively enrolled. The predictive value and ROM of cytological findings were determined with comparison to histologic outcome and/or clinical follow-up.

Results: A total of 521 EUS-FNAs were performed with a malignancy rate of 81.76%. In both classification systems, the absolute ROM of "non-diagnostic," "negative for malignancy," "atypical," "suspicious for malignancy," and "malignant" categories were 48.2%, 2.3%, 78.1%, 100.0%, and 99.4%, respectively. Despite the heterogeneous nature of the "neoplastic: other" category of the PSC system, the absolute ROM for solid lesions was 100%. Pancreatic neoplasm: high-risk/grade category including only two endosonographically solid cases of high-grade intraductal papillary mucinous neoplasms showed 100% ROM. There were no differences between PSC and WHO systems in sensitivity, specificity, and negative and positive predictive values: excluding the "atypical" category, these were 99.7%, 95.6%, 97.7%, and 99.5%, respectively. The "atypical" category considered benign resulted in a higher decrease in validity and negative predictive value, compared to "atypical" considered true malignant (93.6% vs 97.7% and 65.8% vs 97.7%).

Conclusion: For solid pancreatic lesions, the WHO system was identical to the PSC system in terms of ROM and predictive values.

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比较巴氏细胞病理学会系统和世界卫生组织胰胆细胞病理学报告系统对胰腺实体病变所定义的诊断类别的恶性风险和预测价值。

背景：世界卫生组织（WHO）报告系统定义的标准化诊断类别支持在胰腺癌管理中对细胞学检查结果进行跨学科解释：将该分类与巴氏细胞病理学会（PSC）系统在胰腺实体病变的预测价值和恶性风险（ROM）方面进行比较：回顾性队列研究：回顾性纳入2014年至2021年期间在塞格德大学接受内镜超声引导下细针抽吸（EUS-FNA）取样的所有连续胰腺实性病变患者。通过与组织学结果和/或临床随访进行比较，确定了细胞学结果的预测价值和ROM：共进行了521例EUS-FNA，恶性率为81.76%。在两种分类系统中，"非诊断性"、"恶性阴性"、"非典型"、"恶性可疑 "和 "恶性 "类别的绝对ROM分别为48.2%、2.3%、78.1%、100.0%和99.4%。尽管 PSC 系统中的 "肿瘤：其他 "类别具有异质性，但实体病变的绝对 ROM 值为 100%。胰腺肿瘤：高危/高级别 "类别仅包括两例内镜实性高级别导管内乳头状黏液瘤，其ROM为100%。在灵敏度、特异性、阴性预测值和阳性预测值方面，PSC 系统和 WHO 系统没有差异：不包括 "非典型 "类别，它们的灵敏度、特异性、阴性预测值和阳性预测值分别为 99.7%、95.6%、97.7% 和 99.5%。与被认为是真正恶性的 "非典型 "相比，被认为是良性的 "非典型 "类别导致有效性和阴性预测值的下降幅度更大（93.6% vs 97.7% 和 65.8% vs 97.7%）：结论：就胰腺实体病变而言，WHO系统与PSC系统的ROM和预测值相同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.70

自引率

2.40%

发文量

103

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.