Cancer Cytopathology最新文献

{"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,&nbsp;Jędrzej Borowczak MD, PhD,&nbsp;Olivier Choussy MD,&nbsp;Maria Lesnik MD,&nbsp;Nathalie Badois MD,&nbsp;Jerzy Klijanienko MD, PhD, MIAC","doi":"10.1002/cncy.70041","DOIUrl":"10.1002/cncy.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <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>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897583","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 metastatic prostate cancer FNA biopsies","authors":"Deepika Sirohi MD,&nbsp;Chien-Kuang Cornelia Ding MD, PhD,&nbsp;Bradley A. Stohr MD, PhD,&nbsp;Ronald Balassanian MD,&nbsp;Poonam Vohra MD,&nbsp;Rahul Aggarwal MD,&nbsp;Emily Chan MD, PhD,&nbsp;Nancy Y. Greenland MD, PhD","doi":"10.1002/cncy.70038","DOIUrl":"10.1002/cncy.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current American Society of Clinical Oncology guidelines state that patients with metastatic prostate cancer (MPC) should undergo germline and somatic DNA sequencing. The authors examined the utility of next-generation sequencing (NGS) on fine-needle aspiration (FNA) biopsies in which NGS was performed on cell block (CB) and/or smears.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was performed of cytology cases with diagnosis of MPC either before and/or after NGS on FNA material. Clinical and NGS data were obtained from the medical record. Androgen receptor, NKX3.1, INSM1, synaptophysin, chromogranin, Rb, PTEN, and Ki67 immunohistochemical stains were performed on CB if not originally done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Slides and NGS data were available for 46 MPC FNA biopsies from 45 patients from 2015 to 2024. Metastatic sites included 20 lymph node, 12 liver, five lung, four soft tissue, two pleura, two bone, and one adrenal gland. Ten patients (22%) had change or potential change in therapy based on NGS results. For one patient with poorly differentiated carcinoma previously thought to be urothelial, a <i>TMPRSS2:ERG</i> fusion confirmed prostatic origin. NGS confirmed lung origin for one patient diagnosed initially as metastatic prostatic adenocarcinoma. For one patient, NGS demonstrated <i>TP53</i> and <i>RB1</i> mutations, supporting transformation to high-grade neuroendocrine carcinoma. Change or potential change in therapy was planned for two patients with <i>CDK12</i> mutations, one with <i>IDH1</i> mutation, three with <i>BRCA2</i> mutations, and one with <i>PTEN</i> and <i>TP53</i> mutations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>NGS on cytology material showed diagnostic and therapeutic utility in a subset of patients, with 10 of 46 patients (22%) having a change or potential in therapy based on NGS results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891684","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":"Application of the Milan and IAC–IARC–WHO Systems in diagnosing soft tissue and bone tumors of the salivary glands: The Institut Curie experience","authors":"Adam Kowalewski MD, PhD, MIAC,&nbsp;Jędrzej Borowczak MD, PhD,&nbsp;Hervé J. Brisse MD, PhD,&nbsp;Olivier Choussy MD,&nbsp;Jerzy Klijanienko MD, PhD, MIAC","doi":"10.1002/cncy.70040","DOIUrl":"10.1002/cncy.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Soft tissue and bone tumors of the salivary gland were compared using classic 4-tier, Milan System for Reporting Salivary Gland Cytopathology (MSRSGC), and the International Academy of Cytology-International Agency for Research on Cancer-World Health Organization (IAC–IARC–WHO) Reporting System for Soft Tissue Cytopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors retrospectively analyzed 2219 salivary gland fine-needle aspiration (FNA) samples collected at the Institut Curie in Paris between 1954 and 2022. A total of 86 cases (3.9%) were identified as soft tissue and bone tumors, with histological follow-up in 63 cases (73%). Cytology was classified according to the classic European 4-tier system, the MSRSGC, and the IAC–IARC–WHO System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to the MSRSGC, eight cases were classified as nonneoplastic, 30 as benign, one as salivary gland neoplasm of uncertain malignant potential, five as suspicious for malignancy, and 42 as malignant. Benign or malignant nature was accurately assessed in 78 cases (90.7%), with exact histologic-cytologic concordance in 51 cases (59.3%). FNA correctly identified 42 of 44 malignant tumors (95.5%), with exact diagnostic matches in 30 cases (68.2%). The MSRSGC achieved 88.3% overall accuracy, 93.6% sensitivity, and 82.7% specificity. Risk of malignancy (ROM) was comparable for malignant tumors across the classic European system, the MSRSGC, and the IAC–IARC–WHO System, with minor discrepancies observed in benign and indeterminate categories. No cases were assigned as nondiagnostic, atypia of undetermined significance, atypical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite their rarity, soft tissue and bone tumors of the salivary gland can be effectively diagnosed using the MSRSGC, with a high accuracy achieved for malignant cases. Minor discrepancies in ROMs were observed between specific categories of the classic European system, the MSRSGC, and the IAC–IARC–WHO System.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881504","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":"Decoding the mysterious surge in early-onset colorectal cancers","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70032","DOIUrl":"10.1002/cncy.70032","url":null,"abstract":"&lt;p&gt;The change began slowly. In the 1990s, colorectal cancer rates started creeping up by a few percentage points every year in adults who often were told they were too young to have cancer. At the same time, the incidence decreased markedly in those over the age of 55 years. Researchers noticed the diverging trends but were unable to determine why they continued year after year.&lt;/p&gt;&lt;p&gt;By 2019, epidemiological data revealed that the incidence of early-onset colorectal cancer had risen by an alarming 63% in less than 3 decades.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although the mystery behind its increase remains, several large research projects are digging into a wide range of modifiable and nonmodifiable risk factors to determine what may have changed in the 1950s or 1960s to cause the persistent and worrisome uptick.&lt;/p&gt;&lt;p&gt;“The short answer is we don’t know what’s causing it,” says Robin Mendelsohn, MD, clinical director of the Gastroenterology, Hepatology, and Nutrition Service at Memorial Sloan Kettering Cancer Center in New York. “Obviously we want to figure this out, but we also want people to be taken care of promptly because the earlier cancer’s detected, the better the prognosis and treatment.”&lt;/p&gt;&lt;p&gt;In March 2018, Memorial Sloan Kettering opened its Center for Young Onset Colorectal Cancer to focus on patients who are diagnosed before they turn 50 years old. In January 2021, because of growing demand, the center was expanded to include all gastrointestinal cancers. “We’ve unfortunately been busy,” says Dr Mendelsohn, codirector of what is now called the Center for Young Onset Colorectal and Gastrointestinal Cancer. Although the number of early-onset cancers is highest in the 40- to 49-year-old age group, she notes, the biggest increase in incidence has been in the 20- to 29-year-old group.&lt;/p&gt;&lt;p&gt;To date, the center has seen more than 5500 patients, including nearly 3800 with colorectal cancer. Beyond providing coordinated care to patients who often have far different needs than older patients, Dr Mendelsohn says that the center has become a significant source of studies into why their risk has increased. All patients receive a lengthy questionnaire that asks about their history of medications, exposures, and habits to help to answer what might have shifted over the past 70 years.&lt;/p&gt;&lt;p&gt;Similar detective work has been launched by the new Colorectal Cancer Pooling Project (C2P2), which is also aiming to understand the potential role of a long list of modifiable and non-modifiable risk factors. Peter Campbell, PhD, a project leader and a professor of epidemiology and population health at Albert Einstein College of Medicine in New York, says that the logical starting point was a list of 12 known risk factors linked to regular-onset colorectal cancer, including physical inactivity; cigarette smoking; alcohol use; antibiotic use; eating red or processed meat; and eating low levels of fiber, fruits and vegetables, or calcium.&lt;/p&gt;&lt;p&gt;In puzzling over what exp","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773898","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 challenges in urinary cytology: Practical insights from The Paris System for Reporting Urinary Cytology","authors":"Derek B. Allison MD,&nbsp;Christopher J. VandenBussche MD, PhD","doi":"10.1002/cncy.70033","DOIUrl":"10.1002/cncy.70033","url":null,"abstract":"<p>Urinary cytology is an important tool for diagnosing high-grade urothelial carcinoma (HGUC) and plays a vital role in monitoring for disease recurrence. However, its diagnostic utility is often complicated by interpretive challenges, particularly when degenerative artifacts, sparse cellularity, or reactive atypia obscure key cytologic features. The Paris System for Reporting Urinary Cytology has significantly enhanced diagnostic reproducibility by establishing standardized criteria for the diagnosis of HGUC, but misclassification remains a risk, especially when evaluating subtle atypia, tissue fragments, or confounding factors like degenerative changes. One of the most frequent pitfalls in urinary cytology is differentiating HGUC from benign mimics, particularly in specimens affected by prolonged urine exposure, inflammation, or instrumentation artifacts. Similarly, the classification of atypical urothelial cells presents a diagnostic gray zone because its predictive value varies widely, depending on clinical context. Low-grade urothelial neoplasms further complicate risk stratification because these tumors infrequently exfoliate in voided specimens and can appear indistinguishable from reactive urothelial cells in these samples. Consequently, the goal of The Paris System for Reporting Urinary Cytology is to focus on the detection of HGUC to preserve the specificity and the positive predictive value of urinary cytology. Advancements in molecular profiling and artificial intelligence-driven cytopathology promise enhanced reproducibility and risk stratification, refining the role of urinary cytology in precision medicine. However, the success of urinary cytology remains rooted in a balanced approach, integrating morphologic expertise, molecular insights, and clinical data. By applying these essential practices, cytopathologists can improve diagnostic accuracy, reduce misclassification, and optimize patient management.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773899","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":"Cytology-Radiology Correlation Series: Thyroid cytopathology","authors":"Rachel Jug MB, BCh, BAO,&nbsp;Wen-Chi Foo MD,&nbsp;Benjamin Wildman-Tobriner MD,&nbsp;Xiaoyin “Sara” Jiang MD","doi":"10.1002/cncy.70028","DOIUrl":"10.1002/cncy.70028","url":null,"abstract":"<p>Thyroid ultrasound is typically the first step in the workup of thyroid nodules. Ultrasonographic features of thyroid nodules can be used to evaluate their risk of malignancy using risk stratification systems to determine whether a nodule is suspicious enough to warrant a more invasive fine-needle aspiration (FNA) for further evaluation. For this review, the authors described and compared two major risk stratification systems, the American Thyroid Association classification system and the American College of Radiology Thyroid Imaging Reporting and Data System, and explored corresponding ultrasound and cytology findings in the thyroid for commonly encountered entities in cytopathology practice.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681092","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":"Hepatocyte nuclear factor 4 alpha immunocytochemistry: A useful marker for detecting endocervical glandular lesions in alcohol-fixed smears","authors":"Yuri Noda DDS, PhD,&nbsp;Kaori Sando CT,&nbsp;Masato Kita MD, PhD,&nbsp;Koji Tsuta MD, PhD","doi":"10.1002/cncy.70034","DOIUrl":"10.1002/cncy.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatocyte nuclear factor 4 alpha (HNF4α) contributes to tumorigenesis and cancer progression. This study evaluated the diagnostic potential of HNF4α for detecting endocervical glandular lesions (EGLs), including endocervical adenocarcinomas (ECAs), adenocarcinomas in situ (AIS), and lobular endocervical glandular hyperplasias (LEGH) using alcohol-fixed cytological smears.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HNF4α expression was immunocytochemically assessed in alcohol-fixed smears and paired formalin-fixed paraffin-embedded tissue specimens obtained from 14 patients with histologically confirmed EGLs: eight papillomavirus-associated (HPVA) ECAs, one non-NHPVA ECA, two HPVA AIS, and three patients with LEGHs. Three cases of squamous cell carcinomas (SCCs) and two cases of non-neoplastic lesions were also analyzed as non-EGL controls. HNF4α positivity was defined as nuclear staining in one or more cell(s)/slide, regardless of intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histologically confirmed EGL cases were cytologically diagnosed as four adenocarcinomas, eight atypical glandular cells, one misclassified atypical squamous cells of undetermined significance, and one misclassified SCC, with a sensitivity of 85.7% and specificity of 100%. Strong and diffuse nuclear HNF4α expression was observed in atypical glands in both smears and tissue specimens, whereas non-neoplastic glands and non-neoplastic/neoplastic squamous epithelium were HNF4α-negative. HNF4α expression showed 73.7% concordance between tissue and smear samples. Notably, HNF4α immunocytochemistry demonstrated 100% sensitivity and specificity for detecting EGLs, outperforming cytomorphological or immunohistochemical diagnosis (sensitivity, 71.4%; specificity, 100%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HNF4α is a reliable diagnostic marker when using alcohol-fixed smears, showing enhanced accuracy for EGLs detection regardless of human papillomavirus status. Immunocytochemical analysis of HNF4α in cervical smears can be used for EGL detection and early diagnosis of cervical cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666511","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 accuracy and risk stratification of pancreatic cyst fluids diagnosed as mucinous neoplasms without mucinous epithelium","authors":"Priscila Dias Goncalves MD,&nbsp;M. Lisa Zhang MD","doi":"10.1002/cncy.70030","DOIUrl":"10.1002/cncy.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neoplastic mucinous cysts (NMC) are premalignant lesions that can be diagnosed on pancreatic cyst fluid (PCF) based on elevated carcinoembryonic antigen or thick extracellular mucin (ECM) without mucinous epithelium. Under the World Health Organization classification, such cases are considered “pancreaticobiliary neoplasm, low-risk/grade.” This study evaluates the diagnostic accuracy and risk of cysts diagnosed as NMC without mucinous epithelium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>A total of 609 PCF specimens (493 patients) diagnosed as NMC were identified; 279/609 (45.8%) had no mucinous epithelium: 182 and 61 were diagnosed based only on elevated carcinoembryonic antigen ≥192 ng/mL or ECM, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among PCF without mucinous epithelium and with molecular correlation, 110/165 (66.7%) harbored <i>KRAS/GNAS/RNF43</i> mutations. High-risk mutations (<i>TP53</i>/<i>CDKN2A</i>/<i>SMAD4</i>) occurred at similar rates in cysts with low-grade mucinous epithelium as in those without mucinous epithelium (6.5% vs. 3.6%, <i>p</i> = .224). A total of 63/71 (88.7%) resections from cysts without mucinous epithelium were confirmed as NMC: 40 (56.3%) had low-grade dysplasia and 23 (32.4%) had at least high-grade dysplasia. A total of 142/279 (50.9%) PCF without mucinous epithelium were molecularly or histologically confirmed as NMC. No significant differences were found in the rates of new worrisome radiologic features, invasive carcinoma, or disease-related mortality between the groups. Patient survival trended lower in the cohort with mucinous epithelium, though rates were comparable upon subanalysis of only “pancreaticobiliary neoplasm, low-risk/grade” cysts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Even though PCF diagnosed as NMC without mucinous epithelium defaults to a low-risk category, the rates of high-grade neoplasia/high-risk outcomes are comparable to those with low-grade mucinous epithelium, supporting continued utility of carcinoembryonic antigen and ECM as diagnostic criteria for NMC in the absence of mucinous epithelium.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589706","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":"Diagnostic performance of SHOX2 and RASSF1A gene methylation assays in malignant pleural effusion: A systematic review and meta-analysis","authors":"Mohamed Smail Aissani MD,&nbsp;Kyrillos Mahrous Gerges MD,&nbsp;Ahmed Msherghi MD,&nbsp;Hajer Farrara MD,&nbsp;Dawood Alatefi MD,&nbsp;Imane Chenfouh MD,&nbsp;Arwi Omar Kara MBBCh,&nbsp;Maram Abuajamieh MBBCh,&nbsp;Ghada Kareem MBBCh,&nbsp;Mohammed Benhammou MD,&nbsp;Mohamed E. Ali MD,&nbsp;Max Wintermark MD, MAS,&nbsp;Muhammed Elhadi MBBCh, MSc","doi":"10.1002/cncy.70031","DOIUrl":"10.1002/cncy.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malignant pleural effusion (MPE) is a common complication of advanced malignancies, requiring differentiation from benign pleural effusion for appropriate management. Cytology and biopsy have limitations, necessitating more sensitive, less invasive diagnostic techniques. The objective of this study was to evaluate the diagnostic accuracy of methylated <i>SHOX2</i> (short-stature homeobox 2) and <i>RASSF1A</i> (Ras association domain family member 1A) genes in detecting MPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis included studies that compared benign pleural effusion and MPE cohorts using methylation of <i>SHOX2</i> and <i>RASSF1A</i> genes in pleural fluid as the index test and cytology/histopathology as the reference standard. A random-effects model was used to calculate sensitivity, specificity, predictive values, and diagnostic odds ratios. Subgroup analysis assessed performance in lung-predominant versus nonlung-predominant MPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four studies with a total of 534 participants were included. The pooled sensitivity and specificity were 85% (95% confidence interval [CI], 53%–96%; heterogeneity [I²] = 0.00%) and 92% (95% CI, 88%–95%; I² = 24.8%), respectively. The positive and negative predictive values were 93% (95% CI, 85%–97%; I² = 61.5%) and 84% (95% CI, 53%–96%; I² = 0.00%), respectively. The diagnostic odds ratio was 22.78 (95% CI, 11.00–47.17; I² = 25.8%). Subgroup analysis showed a slight decrease in sensitivity (70%; 95% CI, 64%–76%; I² = 0.00%) and specificity (91%; 95% CI, 86%–94%; I² = 26.1%) when excluding the study with a lung cancer-predominant population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combined analysis of <i>SHOX2</i> and <i>RASSF1A</i> methylation demonstrated promising diagnostic accuracy for MPE detection, outperforming cytology. This less invasive method could reduce reliance on more invasive procedures, although further research is needed to confirm its efficacy across diverse populations and cancer types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558195","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":"DICER1 mutations in Bethesda category II, III, and IV thyroid nodules: A mutually exclusive relationship with BRAFV600E mutation","authors":"Yulian Wang MS,&nbsp;Guangqi Li MS,&nbsp;Weimao Kong MS,&nbsp;Jianxia Hu MD,&nbsp;Longnv Bao MS,&nbsp;Xingzhu Pan MS,&nbsp;Xueqing Li MS,&nbsp;Jigang Wang MD, PhD","doi":"10.1002/cncy.70029","DOIUrl":"10.1002/cncy.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate the prevalence and cytological features of <i>Dicer 1</i>, <i>Ribonuclease III</i> (<i>DICER</i>)-mutant fine-needle aspiration (FNA) specimens in thyroid nodules classified as Bethesda II, III, and IV categories. The authors also sought to explore the relationship between <i>DICER1</i> and <i>BRAF</i>^V600E mutations in Bethesda III thyroid nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors collected a series of consecutive FNA cases diagnosed as Bethesda category II, III, and IV from a medical center over the course of 1 year. <i>DICER1</i> exons 24 and 25 and <i>TERT</i> promoter mutations were detected by Sanger sequencing in all cases, and <i>BRAF</i>^V600E mutations were detected by amplification refractory mutation system PCR in Bethesda III and IV cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 899 patients were included in the study. <i>DICER1</i> mutations were identified in 52 patients: 20 in Bethesda category II (6.2%, 20 of 322), 25 in Bethesda category III (4.9%, 25 of 510), and seven in Bethesda category IV (10.4%, 7 of 67). Among the 510 Bethesda III FNA samples, 76 harbored the <i>BRAF</i>^V600E mutation and 25 harbored <i>DICER1</i> mutations. <i>BRAF</i>^V600E and <i>DICER1</i> mutations were mutually exclusive. In Bethesda category II and III cases, patients with <i>DICER1</i>-mutant nodules were younger and had larger nodule volumes compared to those without <i>DICER1</i> mutations. All <i>DICER1</i>-mutant Bethesda III FNAs were classified as atypia of undetermined significance (AUS)-other. <i>TERT</i> promoter mutations (c. -118G&gt;T and c. -144 C&gt;T) were identified in two FNA samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study suggest that <i>DICER1</i>-mutant nodules are unlikely to be <i>BRAF</i>-mutant carcinomas. Further study of the molecular characteristics of <i>DICER1</i>-mutant FNAs will contribute to more accurate cytological diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 8","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551026","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}