Abstract:
The World Health Organization (WHO), the International Academy of Cytology, and the International Agency for Research on Cancer have developed an approach to standardized reporting of pancreaticobiliary cytopathology. The WHO Reporting System for Pancreaticobiliary Cytopathology (WHO System) revises the Papanicolaou Society of Cytopathology (PSC) System for Reporting Pancreaticobiliary Cytology published in 2015 and replaces the 6 PSC categories with 7 categories: \"Insufficient/Inadequate/Nondiagnostic\"; \"Benign/Negative for malignancy\"; \"Atypical\"; \"Pancreaticobiliary neoplasm, low risk/grade (PaN-low)\"; \"Pancreatic neoplasm, high risk/grade (PaN-High)\"; \"Suspicious for malignancy\"; and \"Malignant\". In the PSC system, there is a single category for \"Neoplastic\" lesions that includes 2 groups, 1 for benign neoplasms and 1 named \"Neoplastic-other\", dominated by premalignant intraductal neoplasms primarily intraductal papillary mucinous neoplasms and low-grade malignant neoplasms (pancreatic neuroendocrine tumors (PanNET) and solid pseudopapillary neoplasms (SPN). In the WHO System, benign neoplasms with virtually no risk of malignancy are included in the \"Benign\" category and low-grade malignancies (PanNET and SPN) are included in the \"Malignant\" category, as per the 5th edition of the WHO Classification of Digestive System Tumors, while the non-invasive pre-malignant lesions of the ducts are divided by the cytomorphological grade of the epithelium into PaN-low and PaN-high with distinctly different risks of malignancy. Within each category, key diagnostic cytopathologic features and the ancillary studies for diagnostic and prognostic evaluation, as well as the implications of diagnosis for patient care and management, are outlined. Reporting and diagnostic management options recognize the variations in the availability of diagnostic and prognostic ancillary testing modalities in low- and middle-income countries.
摘要:
世界卫生组织(WHO),国际细胞学学会,国际癌症研究机构已经开发了一种胰胆管细胞病理学标准化报告方法。WHO胰胆管细胞病理学报告系统(WHO系统)修订了Papanicolaou细胞病理学学会(PSC)2015年发布的胰胆管细胞学报告系统,并将6个PSC类别替换为7个类别:“不足/不足/非诊断性”;“良性/阴性恶性肿瘤”;“非典型胆道”;低风险/等级(PaN-低)\“;\”胰腺肿瘤,高风险/等级(PaN-高)\";\"可疑恶性肿瘤\"和\"恶性\"。在PSC系统中,“肿瘤”病变有一个类别,包括2组,1用于良性肿瘤,1名为“肿瘤-其他”,以癌前导管内肿瘤为主,主要是导管内乳头状黏液性肿瘤和低度恶性肿瘤(胰腺神经内分泌肿瘤(PanNET)和实性假乳头状肿瘤(SPN)。在WHO系统中,几乎没有恶性肿瘤风险的良性肿瘤包括在“良性”类别中,低度恶性肿瘤(PanNET和SPN)包括在“恶性”类别中,根据世界卫生组织第5版消化系统肿瘤分类,而导管的非侵入性癌前病变根据上皮的细胞形态学分级分为PaN低和PaN高,恶性肿瘤的风险明显不同。在每个类别中,关键的诊断性细胞病理学特征以及诊断和预后评估的辅助研究,以及诊断对患者护理和管理的影响,概述了。报告和诊断管理选择认识到低收入和中等收入国家诊断和预后辅助测试模式的可用性存在差异。