The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) recommends an upper limit of 10% for atypia of undetermined significance (AUS). Recent data suggest that this category might be overused when the rate of cases with molecular positive results is low. As a quality metric, the AUS and positive call rates for this facility’s cytology laboratory and each cytopathologist (CP) were calculated.
Methods
A retrospective analysis of all thyroid cytology cases in a 4.5-year period was performed. Cases were stratified by TBSRTC, and molecular testing results were collected for indeterminate categories. The AUS rate was calculated for each CP and the laboratory. The molecular positive call rate (PCR) was calculated with and without the addition of currently negative to the positive results obtained from the ThyroSeq report.
Results
A total of 7535 cases were classified as nondiagnostic, 7.6%; benign, 69%; AUS, 17.5%; follicular neoplasm/suspicious for follicular neoplasm, 1.4%; suspicious for malignancy, 0.7%; and malignant, 3.8%. The AUS rate for each CP ranged from 9.9% to 36.8%. The overall PCR was 24% (range, 13%–35.6% per CP). When including cases with currently negative results, the PCR increased to 35.5% for the cytology laboratory (range, 13%–42.6% per CP). Comparison analysis indicates a combination of overcalling benign cases and, less frequently, undercalling of higher TBSRTC category cases.
Conclusions
The AUS rate in the context of PCR is a useful metric to assess cytology laboratory and cytopathologists’ performance. Continuous feedback on this metric could help improve the overall quality of reporting thyroid cytology.
{"title":"Atypia of undetermined significance and ThyroSeq v3–positive call rates as quality control metrics for cytology laboratory performance","authors":"Odille Mejia-Mejia MD, Andres Bravo-Gonzalez MD, Monica Sanchez-Avila MD, Youley Tjendra MD, Rodrigo Santoscoy MD, Katherine Drews-Elger MD PhD, Yiqin Zuo MD PhD, Camilo Arias-Abad PhD, Carmen Gomez MD, Monica Garcia-Buitrago MD, Mehrdad Nadji MD, Merce Jorda MD PhD MBA, Jaylou M. Velez-Torres MD, Roberto Ruiz-Cordero MD","doi":"10.1002/cncy.22821","DOIUrl":"10.1002/cncy.22821","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) recommends an upper limit of 10% for atypia of undetermined significance (AUS). Recent data suggest that this category might be overused when the rate of cases with molecular positive results is low. As a quality metric, the AUS and positive call rates for this facility’s cytology laboratory and each cytopathologist (CP) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all thyroid cytology cases in a 4.5-year period was performed. Cases were stratified by TBSRTC, and molecular testing results were collected for indeterminate categories. The AUS rate was calculated for each CP and the laboratory. The molecular positive call rate (PCR) was calculated with and without the addition of currently negative to the positive results obtained from the ThyroSeq report.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 7535 cases were classified as nondiagnostic, 7.6%; benign, 69%; AUS, 17.5%; follicular neoplasm/suspicious for follicular neoplasm, 1.4%; suspicious for malignancy, 0.7%; and malignant, 3.8%. The AUS rate for each CP ranged from 9.9% to 36.8%. The overall PCR was 24% (range, 13%–35.6% per CP). When including cases with currently negative results, the PCR increased to 35.5% for the cytology laboratory (range, 13%–42.6% per CP). Comparison analysis indicates a combination of overcalling benign cases and, less frequently, undercalling of higher TBSRTC category cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The AUS rate in the context of PCR is a useful metric to assess cytology laboratory and cytopathologists’ performance. Continuous feedback on this metric could help improve the overall quality of reporting thyroid cytology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 8","pages":"481-490"},"PeriodicalIF":2.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140570161","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}
<p>In August 2017, unusually warm waters in the western Gulf of Mexico helped a sputtering tropical storm to re-form into what would become the most damaging hurricane in recorded Texas history. Hurricane Harvey dumped a record 52 inches of rain into Houston’s Cedar Bayou and flooded the heavily industrialized Houston Ship Canal along with the petrochemical facilities lining its banks and at least 13 Superfund sites.</p><p>When the floodwaters receded, the tons of chemical contaminants left behind brought a worrisome new trend into sharp relief: Climate change may be significantly increasing some communities’ exposure to carcinogens. That exposure is being felt most heavily by communities already bearing the brunt of health inequities, compounding the danger. After climate scientists calculated that nearly 30% of Harvey’s rainfall could be attributed to global warming, a 2022 study estimated that climate change was responsible for up to half of all flooded properties in Harris County, which includes Houston.<span><sup>1</sup></span> Low-income Latino neighborhoods, such as the ones near the ship canal, were hit the hardest.</p><p>Leticia Nogueira, PhD, MPH, scientific director of health services research at the American Cancer Society, says that the hurricane triggered an epiphany of how the same extracting processes that release greenhouse gases into the atmosphere—the burning of fossil fuels—are also releasing carcinogens into surrounding communities. “I had to witness a very acute, very extreme exposure to make the connection in my brain, but this is happening in many communities in a longer-term, lower dose all the time,” she says. “We’re just not thinking about it.”</p><p>Increasingly extreme events—hurricanes, floods, wildfires, heat waves, and droughts among them—are helping Dr Nogueira and other researchers to connect the dots between climate change and higher cancer risks and worse outcomes for patients diagnosed with malignancies. The individual and synergistic effects of climate change and natural disasters fueled by global warming, they warn, are threatening to undo decades of progress in cancer prevention, detection, and treatment. The growing threat, however, may create a new opening to shine a light on the widening health disparities in vulnerable communities as well as the global consequences of doing nothing to address a warming planet.</p><p>Parsing the environmental contributors to diseases with multifactorial causes such as skin cancer can be tricky, says Eva Rawlings Parker, MD, assistant professor of dermatology at Vanderbilt University Medical Center in Nashville, Tennessee. Even so, she concluded in a review of available data that “strong circumstantial evidence supports the hypothesis that factors related to climate change, including stratospheric ozone depletion, global warming, and ambient air pollution, have likely contributed” to the growing global incidence of skin cancer.<span><sup>2</sup></span></p><p>Higher temper
{"title":"Growing cancer risks on a warming planet","authors":"Bryn Nelson PhD, William Faquin MD, PhD","doi":"10.1002/cncy.22819","DOIUrl":"https://doi.org/10.1002/cncy.22819","url":null,"abstract":"<p>In August 2017, unusually warm waters in the western Gulf of Mexico helped a sputtering tropical storm to re-form into what would become the most damaging hurricane in recorded Texas history. Hurricane Harvey dumped a record 52 inches of rain into Houston’s Cedar Bayou and flooded the heavily industrialized Houston Ship Canal along with the petrochemical facilities lining its banks and at least 13 Superfund sites.</p><p>When the floodwaters receded, the tons of chemical contaminants left behind brought a worrisome new trend into sharp relief: Climate change may be significantly increasing some communities’ exposure to carcinogens. That exposure is being felt most heavily by communities already bearing the brunt of health inequities, compounding the danger. After climate scientists calculated that nearly 30% of Harvey’s rainfall could be attributed to global warming, a 2022 study estimated that climate change was responsible for up to half of all flooded properties in Harris County, which includes Houston.<span><sup>1</sup></span> Low-income Latino neighborhoods, such as the ones near the ship canal, were hit the hardest.</p><p>Leticia Nogueira, PhD, MPH, scientific director of health services research at the American Cancer Society, says that the hurricane triggered an epiphany of how the same extracting processes that release greenhouse gases into the atmosphere—the burning of fossil fuels—are also releasing carcinogens into surrounding communities. “I had to witness a very acute, very extreme exposure to make the connection in my brain, but this is happening in many communities in a longer-term, lower dose all the time,” she says. “We’re just not thinking about it.”</p><p>Increasingly extreme events—hurricanes, floods, wildfires, heat waves, and droughts among them—are helping Dr Nogueira and other researchers to connect the dots between climate change and higher cancer risks and worse outcomes for patients diagnosed with malignancies. The individual and synergistic effects of climate change and natural disasters fueled by global warming, they warn, are threatening to undo decades of progress in cancer prevention, detection, and treatment. The growing threat, however, may create a new opening to shine a light on the widening health disparities in vulnerable communities as well as the global consequences of doing nothing to address a warming planet.</p><p>Parsing the environmental contributors to diseases with multifactorial causes such as skin cancer can be tricky, says Eva Rawlings Parker, MD, assistant professor of dermatology at Vanderbilt University Medical Center in Nashville, Tennessee. Even so, she concluded in a review of available data that “strong circumstantial evidence supports the hypothesis that factors related to climate change, including stratospheric ozone depletion, global warming, and ambient air pollution, have likely contributed” to the growing global incidence of skin cancer.<span><sup>2</sup></span></p><p>Higher temper","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 4","pages":"200-201"},"PeriodicalIF":3.4,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533838","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}
Sandra N. Freiberger PhD, Kristian Ikenberg MD, Demi van Egmond, Sofie Claerhout PhD, Tom van Wezel PhD, Isabelle Vanden Bempt PharmD, PhD, Jeroen N. van Rossem MSc, Simon A. Mueller MD, Paul M Clement MD PhD, Vincent Vander Poorten MD PhD MSc, Danielle Cohen MD PhD, Esther Hauben MD, Niels J. Rupp MD
Background
Diagnosis of salivary gland neoplasms is challenging, especially on cytological specimens acquired by fine-needle aspiration. The recently implemented standardized Milan system for reporting salivary gland cytopathology provides an estimated risk of malignancy (ROM); yet, for two of the categories, the diagnosis of the lesion remains unclear. However, a precise diagnosis is desirable for optimal patient management, including planning of surgery and imaging procedures.
Methods
Cytological specimens (n = 106) were subjected to molecular analysis using the SalvGlandDx panel. The risk of malignancy was calculated for each detected alteration based on the diagnosis of the resection specimen. By taking into account the molecular alterations, their associated ROM, the clinical and cytological features, and the current literature, the Milan category was evaluated.
Results
Of n = 63 technically valid cases, 76% revealed a molecular alteration. A total of 94% of these molecularly altered cases could be assigned to a different Milan category when additionally taking molecular results into account. In only 2% of the salivary gland neoplasms of uncertain malignant potential, in which a molecular alteration was detected, the classification remained salivary gland neoplasms of uncertain malignant potential.
Conclusion
Molecular analysis of cytological specimens provides a benefit in classifying salivary gland neoplasms on fine-needle aspiration. It can improve the ROM estimation and thus help to assign cases of formerly unknown malignant potential to clearly benign or malignant categories.
背景：唾液腺肿瘤的诊断极具挑战性，尤其是通过细针穿刺获得的细胞学标本。最近实施的米兰涎腺细胞病理学报告标准化系统提供了估计的恶性肿瘤风险（ROM）；然而，其中两个类别的病变诊断仍不明确。然而，精确的诊断有助于优化患者管理，包括手术和影像学检查的规划：方法：使用 SalvGlandDx 面板对细胞学标本（n = 106）进行分子分析。根据切除标本的诊断结果，计算出每个检测到的改变的恶性风险。通过考虑分子改变、其相关的ROM、临床和细胞学特征以及当前文献，对米兰分类进行了评估：在 n = 63 个技术上有效的病例中，76% 发现了分子改变。在这些分子改变的病例中，94%的病例在考虑分子结果后可归入不同的米兰分类。在检测到分子改变的恶性程度不确定的唾液腺肿瘤中，只有2%的病例的分类仍然是恶性程度不确定的唾液腺肿瘤：结论：细胞学标本的分子分析有助于对细针穿刺唾液腺肿瘤进行分类。结论：分子分析有助于对细针穿刺唾液腺肿瘤进行分类，它可以提高ROM估计值，从而帮助将以前恶性潜能未知的病例明确归入良性或恶性类别。
{"title":"Molecular analysis using SalvGlandDx improves risk of malignancy estimation and diagnosis of salivary gland cytopathology: An exploratory multicenter study","authors":"Sandra N. Freiberger PhD, Kristian Ikenberg MD, Demi van Egmond, Sofie Claerhout PhD, Tom van Wezel PhD, Isabelle Vanden Bempt PharmD, PhD, Jeroen N. van Rossem MSc, Simon A. Mueller MD, Paul M Clement MD PhD, Vincent Vander Poorten MD PhD MSc, Danielle Cohen MD PhD, Esther Hauben MD, Niels J. Rupp MD","doi":"10.1002/cncy.22814","DOIUrl":"10.1002/cncy.22814","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diagnosis of salivary gland neoplasms is challenging, especially on cytological specimens acquired by fine-needle aspiration. The recently implemented standardized Milan system for reporting salivary gland cytopathology provides an estimated risk of malignancy (ROM); yet, for two of the categories, the diagnosis of the lesion remains unclear. However, a precise diagnosis is desirable for optimal patient management, including planning of surgery and imaging procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cytological specimens (<i>n</i> = 106) were subjected to molecular analysis using the SalvGlandDx panel. The risk of malignancy was calculated for each detected alteration based on the diagnosis of the resection specimen. By taking into account the molecular alterations, their associated ROM, the clinical and cytological features, and the current literature, the Milan category was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of <i>n</i> = 63 technically valid cases, 76% revealed a molecular alteration. A total of 94% of these molecularly altered cases could be assigned to a different Milan category when additionally taking molecular results into account. In only 2% of the salivary gland neoplasms of uncertain malignant potential, in which a molecular alteration was detected, the classification remained salivary gland neoplasms of uncertain malignant potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Molecular analysis of cytological specimens provides a benefit in classifying salivary gland neoplasms on fine-needle aspiration. It can improve the ROM estimation and thus help to assign cases of formerly unknown malignant potential to clearly benign or malignant categories.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 7","pages":"435-446"},"PeriodicalIF":2.6,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334787","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}
Tarik M. Elsheikh MD, Matthew Thomas MD, Jennifer Brainard MD, Jessica Di Marco CT(ASCP), Erica Manosky CT(ASCP), Bridgette Springer CT(ASCP), Dawn Underwood MS CT(ASCP), Deborah J. Chute MD
Background
Noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP) was introduced in 2016 replacing noninvasive follicular variant of papillary thyroid carcinoma, with recommendations to label them “noncancer.” To avoid reducing risk of malignancy (ROM) and overdiagnosing NIFTP as malignant, some authors required restricted cytologic criteria (RC) for a definitive diagnosis of papillary thyroid carcinoma (PTC), including papillae, psammoma bodies. or ≥3 nuclear pseudoinclusions. Since then, NIFTP criteria have been revised, biologic behavior better understood, and incidence reported to be much lower than initially anticipated. This study examines the impact of RC on PTC cytologic diagnoses, ROM, and detection of clinically significant carcinomas (CSC).
Materials and Methods
A total of 207 thyroid FNAs originally diagnosed as PTC and suspicious for PTC (SPTC) with surgical follow-up were evaluated. RC were retrospectively applied to cases as a requirement for diagnosing PTC, and cases that did not meet RC were reclassified as SPTC. ROMs and diagnostic accuracies of pre- and post-RC diagnoses were correlated with followup CSC.
Results
RC were met in 118/142 (83%) and 20/65 (31%) of cases originally diagnosed as PTC and SPTC, respectively. Post-RC, 29% (19/65) of CSC originally diagnosed as SPTC were upgraded to PTC, and 17% (24/142) of CSC originally diagnosed as PTC were downgraded to SPTC. No NIFTPs were diagnosed as malignant.
Conclusions
RC should not be required for a definitive diagnosis of PTC when other nuclear features of PTC are diffuse and overt. Applying RC, however, helps the pathologist arrive at a more definitive diagnosis of PTC in suspicious cases.
{"title":"Papillae, psammoma bodies, and/or many nuclear pseudoinclusions are helpful criteria but should not be required for a definitive cytologic diagnosis of papillary thyroid carcinoma: An institutional experience of 207 cases with surgical follow up","authors":"Tarik M. Elsheikh MD, Matthew Thomas MD, Jennifer Brainard MD, Jessica Di Marco CT(ASCP), Erica Manosky CT(ASCP), Bridgette Springer CT(ASCP), Dawn Underwood MS CT(ASCP), Deborah J. Chute MD","doi":"10.1002/cncy.22817","DOIUrl":"10.1002/cncy.22817","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP) was introduced in 2016 replacing noninvasive follicular variant of papillary thyroid carcinoma, with recommendations to label them “noncancer.” To avoid reducing risk of malignancy (ROM) and overdiagnosing NIFTP as malignant, some authors required restricted cytologic criteria (RC) for a definitive diagnosis of papillary thyroid carcinoma (PTC), including papillae, psammoma bodies. or ≥3 nuclear pseudoinclusions. Since then, NIFTP criteria have been revised, biologic behavior better understood, and incidence reported to be much lower than initially anticipated. This study examines the impact of RC on PTC cytologic diagnoses, ROM, and detection of clinically significant carcinomas (CSC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 207 thyroid FNAs originally diagnosed as PTC and suspicious for PTC (SPTC) with surgical follow-up were evaluated. RC were retrospectively applied to cases as a requirement for diagnosing PTC, and cases that did not meet RC were reclassified as SPTC. ROMs and diagnostic accuracies of pre- and post-RC diagnoses were correlated with followup CSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RC were met in 118/142 (83%) and 20/65 (31%) of cases originally diagnosed as PTC and SPTC, respectively. Post-RC, 29% (19/65) of CSC originally diagnosed as SPTC were upgraded to PTC, and 17% (24/142) of CSC originally diagnosed as PTC were downgraded to SPTC. No NIFTPs were diagnosed as malignant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RC should not be required for a definitive diagnosis of PTC when other nuclear features of PTC are diffuse and overt. Applying RC, however, helps the pathologist arrive at a more definitive diagnosis of PTC in suspicious cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 6","pages":"348-358"},"PeriodicalIF":3.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334788","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}
Tikamporn Jitpasutham MD, Stefen Andrianus MD, Maria Gubbiotti MD, PhD, Vania Nosé MD, PhD, Zubair W. Baloch MD, PhD, Emilio Madrigal MD, William C. Faquin MD, PhD
Although DICER1 patients are younger, and PTEN patients have more multinodular disease, DICER1 and PTEN FNAs reveal many cytologic similarities. Awareness of these genetic cohorts can identify patients at risk for thyroid cancer.
{"title":"Thyroid nodules with DICER1 mutation or PTEN alteration: A comparative cytologic, clinical, and molecular study of 117 FNA cases","authors":"Tikamporn Jitpasutham MD, Stefen Andrianus MD, Maria Gubbiotti MD, PhD, Vania Nosé MD, PhD, Zubair W. Baloch MD, PhD, Emilio Madrigal MD, William C. Faquin MD, PhD","doi":"10.1002/cncy.22811","DOIUrl":"10.1002/cncy.22811","url":null,"abstract":"<p>Although <i>DICER1</i> patients are younger, and PTEN patients have more multinodular disease, <i>DICER1</i> and PTEN FNAs reveal many cytologic similarities. Awareness of these genetic cohorts can identify patients at risk for thyroid cancer.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 6","pages":"370-385"},"PeriodicalIF":3.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334789","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}
Marc P. Pusztaszeri MD, PhD, Mauro Saieg MD, PhD, Zubair W. Baloch MD, PhD
The ever-increasing popularity of standardized systems for reporting cytopathology has led in part to much attention to and importance of the risk stratification schemes, especially the risks of malignancy (ROMs), which are associated with the different diagnostic categories and upon which recommendations for clinical management are based. However, it is well known that the ROM calculations are based on retrospective reviews of the existing literature, representing a heterogeneous patient population, and are plagued by significant biases and variations. Statistically, the ROM represents the post-test probability of malignancy, which changes with the test result and with the prevalence of malignancy (or pretest probability) in an individual practice setting and individual patient presentation. Therefore, the clinical utility of the ROM is questioned and likely needs a second look in the nongynecologic cytopathology reporting systems. In this communication, the authors discuss the status of the ROM estimates according to the most commonly used nongynecologic reporting systems, including for thyroid, salivary glands, and others, highlighting similarities and differences with a focus on the limitations of ROM estimates and their application in clinical practice.
{"title":"Risks of malignancy in the major nongynecologic cytopathology reporting systems: Critiques and discussions","authors":"Marc P. Pusztaszeri MD, PhD, Mauro Saieg MD, PhD, Zubair W. Baloch MD, PhD","doi":"10.1002/cncy.22809","DOIUrl":"10.1002/cncy.22809","url":null,"abstract":"<p>The ever-increasing popularity of standardized systems for reporting cytopathology has led in part to much attention to and importance of the risk stratification schemes, especially the risks of malignancy (ROMs), which are associated with the different diagnostic categories and upon which recommendations for clinical management are based. However, it is well known that the ROM calculations are based on retrospective reviews of the existing literature, representing a heterogeneous patient population, and are plagued by significant biases and variations. Statistically, the ROM represents the post-test probability of malignancy, which changes with the test result and with the prevalence of malignancy (or pretest probability) in an individual practice setting and individual patient presentation. Therefore, the clinical utility of the ROM is questioned and likely needs a second look in the nongynecologic cytopathology reporting systems. In this communication, the authors discuss the status of the ROM estimates according to the most commonly used nongynecologic reporting systems, including for thyroid, salivary glands, and others, highlighting similarities and differences with a focus on the limitations of ROM estimates and their application in clinical practice.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 8","pages":"467-480"},"PeriodicalIF":2.6,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140325041","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 updated College of American Pathologists principles of analytic validation of immunohistochemical assays: A step forward for cytopathology","authors":"Sinchita Roy-Chowdhuri MD, PhD","doi":"10.1002/cncy.22818","DOIUrl":"10.1002/cncy.22818","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"547-548"},"PeriodicalIF":2.6,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140292969","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}
Krisztina Lengyel MD, Daniel J. Lubin MD, Wen-Yu Hsiao MD, Sam Sirotnikov DO, Guangju Luo MD, James W. Roberts MD, Qiuying Shi MD MS, Kelly Magliocca DMD, Melinda M. Lewis MD, Donald L. Sears MD, Ghulam Ilyas MD, Beverly B. Rogers MD, Kartik Viswanathan MD PhD
A comprehensive multipractice cytologic-histologic-molecular correlation of a DICER1-altered thyroid lesion cohort, comprising one of the largest to date.
{"title":"Comprehensive evaluation of cytomorphologic, histologic, and molecular features of DICER1-altered thyroid lesions on FNA: A multipractice experience","authors":"Krisztina Lengyel MD, Daniel J. Lubin MD, Wen-Yu Hsiao MD, Sam Sirotnikov DO, Guangju Luo MD, James W. Roberts MD, Qiuying Shi MD MS, Kelly Magliocca DMD, Melinda M. Lewis MD, Donald L. Sears MD, Ghulam Ilyas MD, Beverly B. Rogers MD, Kartik Viswanathan MD PhD","doi":"10.1002/cncy.22805","DOIUrl":"10.1002/cncy.22805","url":null,"abstract":"<p>A comprehensive multipractice cytologic-histologic-molecular correlation of a <i>DICER1</i>-altered thyroid lesion cohort, comprising one of the largest to date.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 6","pages":"359-369"},"PeriodicalIF":3.4,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193456","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":"Incorporation of DNA methylation profiling into the cytopathology laboratory","authors":"Gloria H. Sura MD, Leomar Y. Ballester MD, PhD","doi":"10.1002/cncy.22810","DOIUrl":"10.1002/cncy.22810","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"543-546"},"PeriodicalIF":2.6,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130724","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}
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