Cancer Cytopathology最新文献_第3页

Prognostic significance of pelvic washing cytology in early stage endometrial cancer: A 10-year matched cohort analysis from a large single institute 盆腔冲洗细胞学检查对早期子宫内膜癌的预后意义：一项来自大型单一研究所的10年匹配队列分析。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-29 DOI: 10.1002/cncy.70057

Minhua Wang MD, PhD, Rita Abi-Raad MD, Adebowale J. Adeniran MD, Uma Krishnamurti MD, PhD, Natalia Buza MD, Pei Hui MD, PhD, Guoping Cai MD, MS, Tong Sun MD, PhD

Background

Pelvic washing (PW) cytology has been excluded from endometrial cancer staging by the 2009 International Federation of Gynecology and Obstetrics (FIGO) criteria, and its prognostic significance in early stage disease remains controversial. In this study, the authors evaluated the clinicopathologic correlates and prognostic impact of positive PW cytology in a large institutional cohort using a matched case–control design.

Methods

A retrospective case–control cohort was created by reviewing PWs for endometrial cancer from 2013 to 2023 in the authors' pathology database. Cases with positive PW were retrieved from consecutive patients who had FIGO 2009 stage I or II endometrial cancer. The control group was comprised of randomly selected patients with negative PWs who were matched to patients in the positive PW group on patient age, tumor histologic subtype, FIGO grade, and disease stage. Cox proportional hazards models and multivariable logistic regression analyses were used to correlate survival outcomes and to identify predictors of cytologic positivity.

Results

The cohort included 88 patients who had positive PW cytology and 223 matched controls. Positive PW cytology was independently associated with significantly worse disease-free survival (hazard ratio, 4.33; p < .001) and demonstrated borderline significance for overall survival (hazard ratio, 1.67; p = .05). The presence of free-floating tumor cells in the fallopian tubes was an independent predictor of positive PW cytology (p < .001).

Conclusions

The current study demonstrates that positive PW cytology is an independent adverse prognostic factor in patients with stage I/II endometrial cancer and suggests that PW cytology status should be considered for accurate risk stratification of patients who have early stage endometrial cancer although it is not part of the current FIGO staging criteria.

背景：盆腔冲洗（PW）细胞学已被2009年国际妇产科联合会（FIGO）标准排除在子宫内膜癌分期之外，其在早期疾病中的预后意义仍存在争议。在这项研究中，作者在一个大型机构队列中使用匹配病例对照设计评估了PW细胞学阳性的临床病理相关性和预后影响。方法：通过回顾2013年至2023年作者病理数据库中子宫内膜癌的PWs，建立回顾性病例对照队列。PW阳性的病例是从FIGO 2009期I或II期子宫内膜癌的连续患者中检索的。对照组由随机选择的PW阴性患者组成，在患者年龄、肿瘤组织学亚型、FIGO分级和疾病分期方面与PW阳性组患者相匹配。使用Cox比例风险模型和多变量逻辑回归分析来关联生存结果并确定细胞学阳性的预测因子。结果：该队列包括88例PW细胞学阳性患者和223例匹配对照。PW细胞学阳性与显著较差的无病生存期独立相关（风险比，4.33;p）结论：本研究表明PW细胞学阳性是I/II期子宫内膜癌患者的一个独立的不良预后因素，提示PW细胞学状态在早期子宫内膜癌患者的准确风险分层中应被考虑，尽管它不是目前FIGO分期标准的一部分。

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引用次数: 0

Diagnostic utility of p53, SMAD4, and the novel biomarker PON2 in FNA of pancreatic ductal adenocarcinoma p53、SMAD4和新型生物标志物PON2在胰腺导管腺癌FNA中的诊断价值

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-29 DOI: 10.1002/cncy.70058

Ruimeng Yang MD, PhD, Catherine Gereg MD, Maria C. Olave MD, Esther Yoon MD, Guoping Cai MD

Background

Accurate cytologic diagnosis of pancreatic ductal adenocarcinoma (PDAC) remains challenging. In this retrospective study, the authors assessed the utility of p53, SMAD4, and paraoxonase-2 (PON2) expression in fine-needle aspiration (FNA) diagnosis of PDAC.

Methods

Cytologic cases with sufficient cell block material were retrieved from pathology archives. p53 and SMAD4 immunostains were performed in two separate cohorts, primary cohort (10 benign and 23 PDAC cases) and indeterminate cohort (3 atypical and 17 suspicious cases). PON2 immunostain was performed in the primary cohort (10 benign and 23 PDAC cases). p53 and SMAD4 immunostains were qualitatively assessed and PON2 test was evaluated by semiquantitative H-score.

Results

In the primary cohort, p53 aberrant expression and SMAD4 loss were identified in 74% and 48% of PDAC cases compared to none in benign lesions. The combination of p53 and SMAD4 achieved a superior performance with an area under the curve (AUC) value of 0.96, compared to either marker alone (AUC = 0.87 and 0.74, respectively). In the indeterminate cohort, p53 aberrant expression or SMAD4 loss was seen in 13 of 17 (76%) malignant follow-up cases. PON2 was variably expressed in PDAC cases with H-scores ranging from 110 to 290, significantly higher in PDACs compared to benign cases (p < .001). Furthermore, strong PON2 expression was seen in two PDAC cases with wild-type p53 and intact SMAD4 expression.

Conclusions

Combined p53 and SMAD4 immunostaining could help improve FNA diagnosis of PDACs, particularly in challenging cases. PON2 is differentially expressed in PDAC cases and may serve as a potential biomarker, warranting further investigation.

背景：胰腺导管腺癌（PDAC）的准确细胞学诊断仍然具有挑战性。在这项回顾性研究中，作者评估了p53、SMAD4和对氧磷酶-2 （PON2）表达在细针穿刺（FNA）诊断PDAC中的应用。方法：从病理档案中检索有足够细胞阻滞材料的细胞学病例。p53和SMAD4免疫染色在两个独立的队列中进行，主要队列（10例良性和23例PDAC）和不确定队列（3例不典型和17例可疑病例）。在原发性队列（10例良性和23例PDAC）中进行PON2免疫染色。定性评价p53和SMAD4免疫染色，半定量h评分评价PON2检测。结果：在原发性队列中，74%和48%的PDAC病例中发现p53异常表达和SMAD4缺失，而良性病变中则没有。p53和SMAD4联合使用的效果更好，曲线下面积（AUC）值为0.96，分别为0.87和0.74。在不确定的队列中，17例（76%）恶性随访病例中有13例出现p53异常表达或SMAD4缺失。PON2在h -评分范围为110 - 290的PDAC病例中表达变化，与良性病例相比，PDAC中PON2的表达明显更高(p)结论：p53和SMAD4联合免疫染色有助于提高FNA对PDAC的诊断，特别是在挑战性病例中。PON2在PDAC病例中有差异表达，可能作为潜在的生物标志物，值得进一步研究。

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引用次数: 0

Analyzing the impact of molecular testing on the cytological diagnosis of thyroid nodules: Insights from our institution's experience 分析分子检测对甲状腺结节细胞学诊断的影响：来自我院经验的见解。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-26 DOI: 10.1002/cncy.70051

Dokpe Y. Emechebe MD, Sushant A. Patil PhD, Timothy Collins BS Ct(Ascp), Lee-Ching Zhu MD, Jan F. Silverman MD, Leslie G. Dodd MD

Background

Fine-needle aspiration cytology (FNAC) is a preferred method for evaluation of thyroid nodules. Under The Bethesda System for Reporting Thyroid Cytopathology, approximately 15%–30% of FNAC results fall into an indeterminate category: atypia of undetermined significance (AUS), follicular neoplasm (FN), and suspicious for malignancy (SFM), Bethesda classes III, IV, and V respectively. Molecular testing of indeterminate nodules helps evaluate the risk of malignancy and guide management decisions. This retrospective study assesses the impact of molecular testing on thyroid nodule classification in our institution, with an emphasis on indeterminate results.

Methods

A 9-year retrospective analysis (January 2015–December 2023) was conducted at the University of North Carolina Health System. FNAC cases were classified per The Bethesda System. Molecular testing results and, when available, surgical pathology outcomes were reviewed. The study compared pre- and post-implementation data of routine reflex molecular testing of thyroid nodule diagnosis.

Results

A total of 3992 thyroid aspirates were evaluated: 490 (12.3%) nondiagnostic (class I), 2096 (52.5%) benign (class II), 1041 (26.1%) AUS (class III), 136 (3.4%) FN (class IV), 89 (2.2%) SFM (class V), and 140 (3.5%) malignant (class VI). Indeterminate cytology (classes III–V) accounted for 32% of all aspirates (n = 1266). Before molecular testing, the AUS rate was 19.8% with an AUS:malignant ratio of 5.4. Post-implementation, the AUS rate rose to 30.1%, with a ratio of 8.9. This increase was statistically significant (p = .029).

Conclusion

Implementation of molecular testing was associated with a significant rise in indeterminate cytologic diagnoses, particularly AUS.

背景：细针穿刺细胞学检查（FNAC）是评估甲状腺结节的首选方法。在Bethesda报告甲状腺细胞病理学系统中，大约15%-30%的FNAC结果属于不确定的类别：不确定意义的非典型性（AUS）、滤泡性肿瘤（FN）和可疑恶性肿瘤（SFM）， Bethesda分类分别为III、IV和V。不确定结节的分子检测有助于评估恶性肿瘤的风险和指导管理决策。本回顾性研究评估分子检测对我们机构甲状腺结节分类的影响，重点是不确定的结果。方法：对北卡罗来纳大学卫生系统的9年回顾性分析（2015年1月- 2023年12月）。FNAC病例按Bethesda系统分类。回顾了分子检测结果和手术病理结果。本研究比较了常规反射分子检测在甲状腺结节诊断中的应用前后数据。结果：共评估了3992例甲状腺抽吸：490例（12.3%）无诊断性（I类），2096例（52.5%）良性（II类），1041例（26.1%）AUS （III类），136例（3.4%）FN （IV类），89例（2.2%）SFM （V类），140例（3.5%）恶性（VI类）。不确定的细胞学（III-V类）占所有抽吸物的32% （n = 1266）。分子检测前，AUS发生率为19.8%，AUS：恶性比值为5.4。实施后，澳元利率上升至30.1%，比率为8.9。这一增加具有统计学意义（p = 0.029）。结论：分子检测的实施与不确定细胞学诊断的显著增加有关，特别是AUS。

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引用次数: 0

Thank You to Reviewers 2025 感谢评论者2025

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-21 DOI: 10.1002/cncy.70054

引用次数: 0

Neutrophil-calibrated atypical squamous cells in ThinPrep urine cytology for detecting squamous differentiation in urothelial carcinoma 中性粒细胞校准的非典型鳞状细胞在ThinPrep尿细胞学检测尿路上皮癌鳞状分化。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-13 DOI: 10.1002/cncy.70055

Ayako Furuhata CT, IAC, PhD, Yuki Teramoto MD, PhD, Sachiko Minamiguchi MD, PhD, Masahiro Hirata CT, IAC, PhD, Hironori Haga MD, PhD

Background

Urothelial carcinoma with squamous differentiation (UCSD) carries adverse outcomes, yet cytological recognition is challenging because keratinized atypical squamous cells (ASCs) often show deceptively low nuclear-to-cytoplasmic ratios. A size-based ASC classification anchored to neutrophils was evaluated as a biological internal reference.

Methods

All cytology specimens were prepared with the ThinPrep liquid-based cytology system. Seventeen urine cytology specimens from histologically confirmed UCSD and 79 cytologically benign (BE) specimens with squamous cells were retrospectively reviewed. ASCs with orangeophilic cytoplasm were subclassified by nuclear size relative to the adjacent neutrophils: ASC-S (small nuclei; >1× neutrophil) and ASC-L (large nuclei; >2× neutrophil). Counts were obtained from five high-power fields. UCSD was stratified by the extent of squamous differentiation (<50% vs. ≥50%).

Results

No ASC-S/L was identified in BE specimens, whereas either subtype was present in 15 of the 17 UCSD cases, which yielded a cohort-level sensitivity of 88% and specificity of 100% for UCSD detection (95% CI, 65.7%–96.7% and 95.4%–100%, respectively). ASC-S was more prevalent than ASC-L, and was observed across Paris System categories—including atypical urothelial cells (AUCs)—whereas ASC-L appeared mainly in suspicious for high-grade urothelial carcinoma/high-grade urothelial carcinoma. ASC-S counts tended to increase with greater histological squamous differentiation, and were detectable even when tissue involvement was <50%.

Conclusions

Neutrophil-calibrated ASC classification provides an objective, biologically grounded framework that aligns cytology with histology in UCSD. Reporting ASC-S/L—particularly ASC-S in equivocal (AUC) specimens—may facilitate earlier recognition of squamous differentiation and inform subsequent tissue evaluation. Prospective, multi-institutional validation with interobserver agreement and receiver operating characteristic–based thresholds is warranted.

背景：尿路上皮癌伴鳞状分化（UCSD）会带来不良后果，但细胞学识别是具有挑战性的，因为角化的非典型鳞状细胞（ASCs）通常表现出较低的核质比。以中性粒细胞为基础的ASC分级作为生物内参进行评估。方法：所有细胞学标本采用ThinPrep液基细胞学系统制备。回顾性分析了17例组织学证实的UCSD尿液细胞学标本和79例细胞学良性（BE）鳞状细胞标本。具有嗜橙色细胞质的ASCs根据其核大小相对于邻近的中性粒细胞进行亚分类：ASC-S（小核，> 1x中性粒细胞）和ASC-L（大核，> 2x中性粒细胞）。计数从五个高倍视场获得。根据鳞状分化程度对UCSD进行分层(结果：在BE标本中未发现ASC-S/L，而在17例UCSD病例中有15例存在ASC-S/L亚型，这使得UCSD检测的队列水平灵敏度为88%，特异性为100% （95% CI，分别为65.7%-96.7%和95.4%-100%）。ASC-S比ASC-L更普遍，并且在巴黎系统类别（包括非典型尿路上皮细胞（auc））中都有观察到，而ASC-L主要出现在怀疑的高级别尿路上皮癌/高级别尿路上皮癌中。结论：中性粒细胞校准的ASC分类提供了一个客观的、生物学基础的框架，使UCSD的细胞学与组织学保持一致。报告ASC-S/ l，特别是模棱两可（AUC）标本中的ASC-S，可能有助于早期识别鳞状分化，并为随后的组织评估提供信息。前瞻性的、多机构的验证与观察者之间的协议和基于接受者操作特征的阈值是必要的。

{"title":"Neutrophil-calibrated atypical squamous cells in ThinPrep urine cytology for detecting squamous differentiation in urothelial carcinoma","authors":"Ayako Furuhata CT, IAC, PhD, Yuki Teramoto MD, PhD, Sachiko Minamiguchi MD, PhD, Masahiro Hirata CT, IAC, PhD, Hironori Haga MD, PhD","doi":"10.1002/cncy.70055","DOIUrl":"10.1002/cncy.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urothelial carcinoma with squamous differentiation (UCSD) carries adverse outcomes, yet cytological recognition is challenging because keratinized atypical squamous cells (ASCs) often show deceptively low nuclear-to-cytoplasmic ratios. A size-based ASC classification anchored to neutrophils was evaluated as a biological internal reference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All cytology specimens were prepared with the ThinPrep liquid-based cytology system. Seventeen urine cytology specimens from histologically confirmed UCSD and 79 cytologically benign (BE) specimens with squamous cells were retrospectively reviewed. ASCs with orangeophilic cytoplasm were subclassified by nuclear size relative to the adjacent neutrophils: ASC-S (small nuclei; >1× neutrophil) and ASC-L (large nuclei; >2× neutrophil). Counts were obtained from five high-power fields. UCSD was stratified by the extent of squamous differentiation (<50% vs. ≥50%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No ASC-S/L was identified in BE specimens, whereas either subtype was present in 15 of the 17 UCSD cases, which yielded a cohort-level sensitivity of 88% and specificity of 100% for UCSD detection (95% CI, 65.7%–96.7% and 95.4%–100%, respectively). ASC-S was more prevalent than ASC-L, and was observed across Paris System categories—including atypical urothelial cells (AUCs)—whereas ASC-L appeared mainly in suspicious for high-grade urothelial carcinoma/high-grade urothelial carcinoma. ASC-S counts tended to increase with greater histological squamous differentiation, and were detectable even when tissue involvement was <50%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neutrophil-calibrated ASC classification provides an objective, biologically grounded framework that aligns cytology with histology in UCSD. Reporting ASC-S/L—particularly ASC-S in equivocal (AUC) specimens—may facilitate earlier recognition of squamous differentiation and inform subsequent tissue evaluation. Prospective, multi-institutional validation with interobserver agreement and receiver operating characteristic–based thresholds is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 11","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278997","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}

引用次数: 0

Assessment of the efficiency and accuracy of an artificial intelligence assistive system in the diagnosis of Pap cervical atypical glandular cell cytology 评估人工智能辅助系统在巴氏宫颈非典型腺细胞细胞学诊断中的效率和准确性。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-09 DOI: 10.1002/cncy.70056

Xin Zhang MD, Xing Dong MD, David Starr MD, Xinru Bai MD, Yingbin Li MD, Terri E. Jones MD, Yixuan Liu MD, Xiaoqian Wang MD, Changzhong Li MS, Xiangchen Wu PhD, Xianxu Zeng MD, PhD, Chengquan Zhao MD

Background

A diagnosis of atypical glandular cells (AGC) on Papanicolaou (Pap) slides is rare but has clinically significant findings associated with high-risk cervical and endometrial lesions. The authors evaluated the efficiency and diagnostic performance of an artificial intelligence (AI)-assisted platform (Riuqian WSI-2400; with the registered trademark AICyte) in identifying AGCs on Pap slides.

Methods

A retrospective analysis of 485 Pap cases was conducted, including 185 cases with AGCs, 50 cases with high-grade squamous intraepithelial lesions, 50 cases with low-grade squamous intraepithelial lesions, and 200 negative cases; of these, 264 cases had histologic correlations. An experienced cytopathologist reviewed all slides using conventional microscopy and AICyte. Then, the same cases were evaluated by two other pathologists using the AICyte system.

Results

The initial study demonstrated a kappa value of 0.744, which indicated strong agreement of the Pap interpretation from the same pathologist between using microscopy and AICyte methods, whereas the average interpretation time was significantly reduced with AICyte (137 vs. 44 seconds). Diagnostic consensus among three pathologists using the AICyte system was strong, with a Kendall W coefficient of 0.802. The AICyte-pathologist consensus reached an exact match with original interpretations in 95.1% of cases. AICyte-assisted interpretations demonstrated improved specificity and diagnostic accuracy for glandular lesions compared with original interpretations while maintaining 100% sensitivity and negative predictive value.

Conclusions

To the authors' knowledge, this is the first study focusing on assessment of AGCs on an artificial intelligence system. The findings demonstrated that the AICyte system offers substantial improvements in efficiency and diagnostic consistency for the interpretation of AGCs and significantly reduces slide reading time. These results support the potential of AI to augment performance, especially in resource-limited settings or high-volume screening environments.

背景：在巴氏涂片上诊断非典型腺细胞（AGC）是罕见的，但与高危宫颈和子宫内膜病变有临床意义。作者评估了人工智能（AI）辅助平台（Riuqian WSI-2400，注册商标为AICyte）在Pap载玻片上识别AGCs的效率和诊断性能。方法：回顾性分析485例Pap患者，其中合并AGCs者185例，合并高级别鳞状上皮内病变者50例，合并低级别鳞状上皮内病变者50例，阴性者200例；其中，264例具有组织学相关性。一位经验丰富的细胞病理学家使用常规显微镜和AICyte检查了所有载玻片。然后，同样的病例由另外两名病理学家使用无细胞系统进行评估。结果：最初的研究显示kappa值为0.744，这表明使用显微镜和AICyte方法对同一病理学家的Pap解释非常一致，而使用AICyte方法的平均解释时间显着缩短（137秒对44秒）。三位病理学家使用AICyte系统的诊断一致性很强，Kendall W系数为0.802。在95.1%的病例中，aicyte -病理学共识与原始解释完全吻合。与原始解释相比，aicyte辅助解释在保持100%敏感性和阴性预测值的同时，提高了腺体病变的特异性和诊断准确性。结论：据作者所知，这是第一个专注于人工智能系统上AGCs评估的研究。研究结果表明，AICyte系统在解释AGCs的效率和诊断一致性方面提供了实质性的改进，并显著缩短了玻片读取时间。这些结果支持人工智能提高性能的潜力，特别是在资源有限的环境或高容量筛选环境中。

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引用次数: 0

FNA biopsy of breast specimens effectively harvests cells for patient-derived organoids modeling ductal carcinoma in situ 乳房标本的FNA活检有效地收集细胞，用于模拟原位导管癌的患者来源的类器官。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-09 DOI: 10.1002/cncy.70052

Julia Ye MD, PhD, Nadine Goldhammer PhD, Poonam Vohra MD, Shruti Warhadpande MS, George C. de Castro MD, Cristian K. Maldonado Rodas BS, Mark M. Moasser MD, Kirithiga Ramalingam MD, MAS, Shoko E. Abe MD, Michael Alvarado MD, Cheryl Ewing MD, Karen M. Goodwin DO, FACS, Rita A. Mukhtar MD, Jasmine M. Wong MD, Laura J. Esserman MD, MBA, Ronald Balassanian MD, Jennifer M. Rosenbluth MD, PhD

Background

Patient-derived organoids (PDOs) generated from benign breast tissue and breast carcinomas have successfully recapitulated their in vivo counterparts. PDOs model tumorigenesis and allow for screening novel therapeutics personalized to individual patients. However, acquiring cells to generate PDOs is cumbersome. This study demonstrates the feasibility of fine-needle aspiration biopsy (FNAB) for harvesting cells for PDOs modeling ductal carcinoma in situ (DCIS) and compares the efficacy with core needle biopsy (CNB).

Methods

Surgical specimens from patients with biopsy-proven DCIS were used for this study. CNB was performed on fresh specimens in the operating room, and tissue was mechanically dissociated before culture in basement membrane extract (BME) and organoid medium to generate PDOs. FNAB was performed in the pathology gross room on fresh specimens, and the aspirate was similarly submitted for culture.

Results

PDOs were successfully generated in 15 of 18 specimens obtained by CNB and seven of 11 specimens obtained by FNAB. The average time to initial organoid growth was 4 days for FNAB specimens compared to 19.3 days for CNB specimens. Tumor cells were seen on seven of 11 FNAB smears and 16 of 18 CNB touch preps. Immunofluorescence staining confirmed the presence of both luminal and myoepithelial cells in derived PDOs.

Conclusions

FNAB effectively obtains cells for PDOs modeling DCIS. CNB yielded PDOs with a high success rate, but they were slow to establish. The time to organoid growth was significantly shorter for FNAB specimens. Thus, FNAB offers an efficient alternative for breast PDO culture and can reduce the time and resources spent on generating PDO cultures.

背景：从良性乳腺组织和乳腺癌中产生的患者源性类器官（PDOs）已经成功地再现了它们在体内的对应体。PDOs模型肿瘤发生和允许筛选新的治疗个性化的个体患者。然而，获取细胞来生成PDOs是很麻烦的。本研究证明了细针穿刺活检（FNAB）收集PDOs模型导管原位癌（DCIS）细胞的可行性，并比较了细针穿刺活检（CNB）的效果。方法：本研究采用活检证实的DCIS患者的手术标本。在手术室对新鲜标本进行CNB，机械解离组织，然后在基底膜提取物（BME）和类器官培养基中培养生成PDOs。在病理总室对新鲜标本进行FNAB，并同样提交抽吸液进行培养。结果：CNB获得的18个标本中有15个成功生成pdo， FNAB获得的11个标本中有7个成功生成pdo。FNAB标本到初始类器官生长的平均时间为4天，而CNB标本为19.3天。11个FNAB涂片中的7个和18个CNB触摸片中的16个可见肿瘤细胞。免疫荧光染色证实在衍生性PDOs中存在管腔和肌上皮细胞。结论：FNAB可有效获取PDOs模型DCIS细胞。CNB产生pdo的成功率很高，但它们建立起来很慢。FNAB标本的类器官生长时间明显缩短。因此，FNAB为乳腺PDO培养提供了一种有效的替代方法，可以减少用于生成PDO培养的时间和资源。

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引用次数: 0

A daunting quest to map the reach and risk of nanoplastics 绘制纳米塑料的影响范围和风险是一项艰巨的任务：在关于微塑料和纳米塑料早期研究的两部分系列文章的第二部分中，研究人员发现了遍布人体的微小颗粒，但警告说，量化和降低风险可能很困难。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-10-03 DOI: 10.1002/cncy.70044

Bryn Nelson PhD, William Faquin MD, PhD

<p>After researchers documented plastic debris floating in the Sargasso Sea in the early 1970s, a spate of similar discoveries followed suit in other marine waters and within a growing list of aquatic creatures.<span><sup>1</sup></span> When more recent studies began turning up evidence of microplastics and even smaller nanoplastics in human tissues and organs—blood, lungs, liver, placenta, and testicles among them—worried scientists started asking how much might be accumulating.</p><p>Then in 2024, researchers led by Matthew Campen, PhD, MSPH, director of the New Mexico Center for Metals in Biology and Medicine at the University of New Mexico in Albuquerque, delivered a bombshell.<span><sup>2</sup></span> For the first time, several independent experts told <i>CytoSource</i>, Dr Campen’s team had provided solid evidence that nanoplastics could cross the blood-brain barrier. Megan Wolff, PhD, MPH, executive director of the Physician and Scientist Network Addressing Plastics and Health in New Paltz, New York, calls it the “last frontier” of the human body.</p><p>“We did the math and said, well, we see about 5000 micrograms per gram,” Dr Campen recalls. “The brain is about 1400 grams so that works out to—my gosh, there’s about 7 grams of plastic in the brain!” It is the approximate weight of a plastic spoon, he explains. That analogy generated multiple headlines as well as blowback from critics who argued that the numbers could have been inflated by the inclusion of lipid contaminants.</p><p>Dr Campen has urged caution over what he concedes is an initial estimate, even as his research has since estimated that the brain may harbor an average of 100 million or more shard-like nanofragments. “We’re comparing it against fresh plastics, and we know we’ve got old plastics in our body,” he says. Because they are so small, nanoplastics also are notoriously difficult to measure.</p><p>To quantify them, some researchers extract and burn them and capture the chemical signatures of the various plastics. Gas chromatography–mass spectrometry can isolate and differentiate among those signatures, but the method is not foolproof. Polyethylene plastics and lipid molecules have comparable architectures that can yield deceptively similar signatures, Dr Campen says. In the brain and other high-lipid tissues, tiny fat globules might not fully digest or wash away with existing methods and could be inadvertently added to the plastics tally.</p><p>Even so, a collaborator at Oklahoma State University reported similar results when he tested human brain samples, and Dr Campen found significantly more accumulation in brain and liver tissues collected in 2024 than in tissues dating back to 2016. “The trend of increasing over time was captivating and something we had a lot of confidence in, even if the total magnitude was adjusted up or down because of the way we digest the samples,” he says.</p><p>Dr Campen’s study also documented an even greater accumulation of nanoplastics in

20世纪70年代初，研究人员记录了马尾藻海中漂浮的塑料碎片，随后在其他海域和越来越多的水生生物中也相继发现了类似的发现当最近的研究开始发现人体组织和器官（包括血液、肺、肝脏、胎盘和睾丸）中存在微塑料甚至更小的纳米塑料的证据时，忧心忡忡的科学家开始询问可能积累了多少塑料。然后在2024年，由新墨西哥大学阿尔伯克基分校新墨西哥生物和医学金属中心主任、MSPH博士马修·坎彭（Matthew Campen）领导的研究人员发布了一个爆炸性消息几位独立专家告诉CytoSource，坎彭博士的团队首次提供了确凿的证据，证明纳米塑料可以穿过血脑屏障。Megan Wolff博士，公共卫生硕士，纽约新帕尔茨塑料与健康医生和科学家网络的执行董事，称其为人体的“最后前沿”。坎彭博士回忆说：“我们做了计算，发现每克含有5000微克。”“大脑大约有1400克，所以算起来——我的天哪，大脑中大约有7克塑料！”他解释说，这大约是一个塑料勺子的重量。这一类比引发了多个头条新闻，也引发了批评人士的反弹，他们认为这些数字可能因包含脂质污染物而被夸大。坎彭博士敦促人们谨慎对待他承认的初步估计，尽管他的研究估计大脑可能平均含有1亿个或更多的碎片状纳米碎片。“我们将其与新鲜塑料进行比较，我们知道我们体内有旧塑料，”他说。因为它们非常小，纳米塑料也是出了名的难以测量。为了量化它们，一些研究人员提取并燃烧它们，并捕捉各种塑料的化学特征。气相色谱-质谱法可以分离和区分这些特征，但该方法不是万无一失的。Campen博士说，聚乙烯塑料和脂质分子具有类似的结构，可以产生看似相似的特征。在大脑和其他高脂组织中，微小的脂肪球可能无法被现有的方法完全消化或洗掉，可能会无意中被添加到塑料中。即便如此，俄克拉荷马州立大学的一位合作者在测试人类大脑样本时也报告了类似的结果，坎彭博士发现，2024年收集的大脑和肝脏组织中的积累量明显高于2016年的组织。他说：“随着时间的推移，这种增加的趋势很吸引人，我们对这种趋势很有信心，即使由于我们消化样本的方式，总幅度会上下调整。”Campen博士的研究还记录了12个被保存下来的痴呆症患者的大脑中纳米塑料的积累量甚至更多。他说，这是有道理的，因为与痴呆症相关的血脑屏障损伤和炎症可能有助于纳米塑料的吸收。他说：“我们很有信心，与正常大脑相比，有更多的大脑，但我们不能真正说这是原因还是结果。”坎彭博士承认，一旦他确信这些数字是真实的，他就会深感担忧。“以前没有人展示过这个。这在我们的数据中非常清楚，无论我们如何重新审视这些数据，”他说。“下一个什么?这种情况会持续下去吗？我们的身体最终会建立某种防御来阻止这些东西进入吗？”如果数量仍然不确定，Wolff博士同意这种趋势是不祥的。在人体内，很少有超过500纳米的塑料颗粒，一些科学家认为，肠道可能会为更大的塑料颗粒提供最初的屏障。有趣的是，坎彭博士和其他研究人员怀疑，一些较大的标记为微塑料的碎片，比如在胎盘中发现的那些，可能是纳米塑料的堆积，它们排列在一起，或者被包装在一起，因为身体的机器试图移动或清除它们。他说：“我们的第一个线索来自肝脏，如果你愿意的话，我们可以在肝脏的脂滴中看到这些颗粒。”类似的分类也出现在肾脏中。他说：“这些是清除器官，它们有处理脂质和其他物质的方法，也许它们在清除塑料方面效率不高，但它们在努力。”换句话说，纳米塑料可能会搭上脂质输送系统的便车，到达富含脂质的大脑。他说：“我们可能会显示塑料在脂肪区含量很高，因为我们只是测量脂肪，我们错了。”“或者它们的存在可能是因为它们是亲脂的。”其他证据支持后一种说法。在脂肪含量约为80%的鲸脂中，坎彭实验室测量到的纳米塑料浓度大约比人脑中的低10倍，人脑的脂肪含量为40%-60%（取决于区域）。“所以不只是脂肪；除了干扰之外，还有其他因素。”医学博士艾伦·沃克曼（Alan Workman）是哈佛医学院（Harvard Medical School）和波士顿马萨诸塞州眼耳医学中心（Massachusetts Eye and Ear）的鼻科和颅骨外科助理教授，对于他来说，复杂的暴露问题即使解决了，也会导致一个更大的问题：那又怎样？即使微塑料和纳米塑料确实与炎症等致癌途径有关，“在这一点上，我们能做些什么呢？”他问道。“如果它们造成了问题，我们该如何限制我们的风险敞口？”与其他令人担忧的化学物质一样，沃尔夫博士等专家表示，降低风险的最佳方法是“关掉水龙头”。然而，这些努力遭到了石油和天然气行业的强烈反对，其中包括《国际塑料条约》（International Plastics Treaty）中一项限制塑料生产的提议，甚至美国许多司法管辖区都出台了禁止使用一次性塑料袋的有限法案。坎彭博士怀疑在不久的将来是否会颁布任何有意义的生产上限。“这太荒谬了，”他说。相反，他建议彻底改变我们管理塑料垃圾的方式可能会产生影响。他说：“整个回收的概念就是个笑话。”他指的是最近的研究表明，实际上只有不到5%的塑料被回收利用相反，他指出，瑞士等国正在通过垃圾焚烧发电等举措减少垃圾总量。更多关于纳米塑料暴露途径的数据和不同人群中纳米塑料水平的比较可以帮助制定基于证据的法规，尽管从灌溉用水到肥料和土壤，纳米塑料无处不在，这可能会使这种比较变得困难。坎彭博士说：“我担心的是，我们的农业系统在很大程度上受到了一个过程的影响，这个过程将塑料放大到我们的食物链中。”这种无处不在也使计算相对风险的任务变得复杂，因为对大多数人来说，接触率已经是100%。动物模型的毒理学研究可能会有所帮助，热那亚·华纳博士说，他是纽瓦克新泽西理工学院化学和环境科学的助理教授，特别是纳米塑料本身很难测量。她说：“我们用塑料喂养动物，我们有一个对照组，我们看看我们看到了什么样的健康影响。”“这只是谜题的一部分，但我们不一定要能够看到（纳米颗粒）才能弄清楚。”Campen博士说，这个领域真正需要的是一种可靠的指标，可以将特定组织中纳米塑料的相对数量与癌症等后果的高风险联系起来——这是一个公认的艰巨任务。然而，自从他最近发表论文以来，多个研究小组提出了合作，包括胶质母细胞瘤、乳腺癌、结肠直肠癌和阑尾癌。他说，通过与癌症专家合作，应用他的实验室的测量能力，“我认为未来几年将是真正有意义的，我们将学到很多东西。”

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引用次数: 0

American College of Radiology–Developed Thyroid Imaging Reporting and Data System 3, 4, and 5 thyroid nodules are distinctive by cytology, genetic imprints, and histology 美国放射学会开发的甲状腺成像报告和数据系统3,4,5甲状腺结节在细胞学，遗传印记和组织学上是独特的。

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-09-29 DOI: 10.1002/cncy.70050

Sanhong Yu MD, PhD, Minhua Wang MD, PhD, Jonathan Langdon MD, PhD, Jessica Zhao MD, Sara I. Pai MD, PhD, John Sinard MD, PhD, Guoping Cai MD, Manju L. Prasad MD, Adebowale J. Adeniran MD

Background

Thyroid nodules, found in up to 68% of adults, can be risk-stratified by high-resolution ultrasound. This study evaluates the concordance between “suspicious” Thyroid Imaging Reporting and Data System (TI-RADS) 3–5 nodules and cytologic and molecular findings from fine-needle aspiration.

Methods

A total of 1199 suspicious thyroid nodules stratified as TI-RADS 3 (n = 384), TI-RADS 4 (n = 569), and TI-RADS 5 (n = 246) were studied. Cytopathologic and molecular results were correlated with clinical data from electronic medical records.

Results

Cytology, histology, and molecular testing revealed a lower risk of malignancy in TI-RADS 3 and 4 nodules compared to TI-RADS 5. Among TI-RADS 3 nodules, 75% (287 of 384) were cytologically benign, with only one case diagnosed as papillary thyroid carcinoma (PTC), and 8 of 48 resected nodules (17%) confirmed as carcinoma. In TI-RADS 4, 10% (56 of 569) were suspicious for or diagnosed as PTC by cytology, with 85 of 130 (65%) resected nodules confirmed as carcinoma. In TI-RADS 5, 44% (109 of 246) were cytologically suspicious for or diagnosed as PTC, and 129 of 154 (84%) resected nodules were malignant. High-risk mutations were more frequent in TI-RADS 5 than in TI-RADS 3 and 4. Overall malignancy rates were 2.0% (eight of 384) for TI-RADS 3, 14% (77 of 569) for TI-RADS 4, and 52% (129 of 246) for TI-RADS 5 nodules.

Conclusion

TI-RADS 3, 4, and 5 nodules demonstrate distinct cytologic, molecular, and histologic features. TI-RADS 3 and 4 nodules are associated with lower malignancy risks, whereas TI-RADS 5 nodules exhibit a high risk of malignancy and are associated with higher mortality.

背景：高分辨率超声可对高达68%的成人甲状腺结节进行风险分层。本研究评估了“可疑”甲状腺影像学报告和数据系统（TI-RADS） 3-5结节与细针穿刺细胞学和分子检查结果之间的一致性。方法：对1199例可疑甲状腺结节进行TI-RADS 3（384例）、TI-RADS 4（569例）、TI-RADS 5（246例）分层分析。细胞病理和分子结果与电子病历的临床数据相关。结果：细胞学、组织学和分子检测显示，与TI-RADS 5相比，TI-RADS 3和4结节的恶性风险较低。在384例TI-RADS 3结节中，75%（287例）为细胞学良性，其中只有1例诊断为甲状腺乳头状癌（PTC）， 48例切除结节中有8例（17%）确诊为癌。在TI-RADS中，10%（569例中有56例）被细胞学怀疑或诊断为PTC， 130例切除结节中有85例（65%）被确诊为癌。在TI-RADS 5中，44%（246例中有109例）的细胞学可疑或诊断为PTC， 154例中有129例（84%）的切除结节为恶性结节。高危突变在TI-RADS 5中比在TI-RADS 3和4中更常见。TI-RADS 3的总恶性率为2.0%（384例中有8例），TI-RADS 4的总恶性率为14%（569例中有77例），TI-RADS 5结节的总恶性率为52%（246例中有129例）。结论：TI-RADS 3、4和5结节表现出不同的细胞学、分子和组织学特征。TI-RADS 3和4型结节与较低的恶性风险相关，而TI-RADS 5型结节表现出较高的恶性风险，并与较高的死亡率相关。

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引用次数: 0

The birth, life, and death of a cytopathology board examination question 生、活、死是一个细胞病理板的检查问题

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology

Pub Date : 2025-09-27 DOI: 10.1002/cncy.70049

Roseann I. Wu MD, MPH, Ritu Nayar MD, Gary W. Procop MD, MS, MEd

Have you ever wondered how a particular cytopathology question ended up on your anatomic pathology primary certification examination or the cytopathology subspecialty certification examination? This is how it happens.

The validity of high-stakes certifications, such as those administered by the American Board of Pathology (ABPath), is supported by psychometric evidence.¹ The qualifications of the individuals who write and review the examination items (i.e., questions) and the process by which the items are reviewed, edited, improved upon, curated, and eventually eliminated are of paramount importance to the validity of the examination.²

你有没有想过一个特定的细胞病理学问题是如何出现在你的解剖病理学初级认证考试或细胞病理学亚专业认证考试中的？事情是这样发生的。高风险认证的有效性，例如由美国病理委员会（ABPath）管理的认证，是由心理测量学证据支持的编写和审查考试项目（即问题）的个人的资格，以及审查、编辑、改进、策划和最终取消这些项目的过程，对考试的有效性至关重要

引用次数: 0