Abstract：
OBJECTIVE: Fine-needle aspiration (FNA) of ovarian cyst fluid remains useful for certain clinical circumstances despite low sensitivity and potential safety concerns. The current study aimed to reevaluate the performance of ovarian cystic fluid cytology following American College of Obstetricians and Gynecologists guidelines using a single-institution cohort.
METHODS: A total of 507 ovarian cyst FNA cases from 2013 to 2023 were reviewed. Patients\' demographics and clinical and radiologic information were collected through the electronic database. The performance was calculated using corresponding surgical pathology diagnosis as the gold standard.
RESULTS: Overall, cytologic diagnoses were nondiagnostic (ND), negative for malignancy (NFM), atypical (ATY), suspicious for malignancy (SFM), and malignant (M) in 5 (1.0%), 478 (94.3%), 14 (2.7%), 2 (0.4%), and 8 (1.6%) cases, respectively. Among 349 specimens (68.8%) that had a corresponding surgical pathology, the rate of malignancy (including borderline tumors) was 1.2% (4 of 325) in NFM, 72.7% in ATY (8 of 11), and 100% in both SFM (2 of 2) and M (8 of 8) specimens. Considering NFM and ATY as negative results and SFM and M as positive results, overall, the sensitivity of ovarian cystic fluid cytology was 45.4% and the specificity was 100%.
CONCLUSIONS: As an uncommon test, ovarian cystic fluid cytology has moderate sensitivity and high specificity. Despite limitations, ovarian cystic FNA cytology remains a valuable diagnostic tool in certain aspects.
METHODS: A total of 507 ovarian cyst FNA cases from 2013 to 2023 were reviewed. Patients\' demographics and clinical and radiologic information were collected through the electronic database. The performance was calculated using corresponding surgical pathology diagnosis as the gold standard.
RESULTS: Overall, cytologic diagnoses were nondiagnostic (ND), negative for malignancy (NFM), atypical (ATY), suspicious for malignancy (SFM), and malignant (M) in 5 (1.0%), 478 (94.3%), 14 (2.7%), 2 (0.4%), and 8 (1.6%) cases, respectively. Among 349 specimens (68.8%) that had a corresponding surgical pathology, the rate of malignancy (including borderline tumors) was 1.2% (4 of 325) in NFM, 72.7% in ATY (8 of 11), and 100% in both SFM (2 of 2) and M (8 of 8) specimens. Considering NFM and ATY as negative results and SFM and M as positive results, overall, the sensitivity of ovarian cystic fluid cytology was 45.4% and the specificity was 100%.
CONCLUSIONS: As an uncommon test, ovarian cystic fluid cytology has moderate sensitivity and high specificity. Despite limitations, ovarian cystic FNA cytology remains a valuable diagnostic tool in certain aspects.
摘要：
目的：卵巢囊肿液的细针穿刺（FNA）在某些临床情况下仍然有用，尽管敏感性低和潜在的安全性问题。本研究旨在使用单机构队列，按照美国妇产科医师学会指南重新评估卵巢囊肿液细胞学的表现。
方法：回顾性分析2013-2023年507例卵巢囊肿FNA病例。通过电子数据库收集患者的人口统计学以及临床和放射学信息。以相应的手术病理诊断为金标准计算表现。
结果：总体而言，细胞学诊断为非诊断性（ND），恶性肿瘤（NFM）阴性，非典型(ATY)，可疑恶性肿瘤（SFM），恶性（M）5（1.0%），478（94.3%），14（2.7%），2（0.4%），和8例(1.6%)，分别。在349例（68.8%）有相应手术病理的标本中，在NFM中，恶性肿瘤（包括交界性肿瘤）的发生率为1.2％（325个中的4个），ATY中的72.7%(11个中的8个)，在SFM(2个中的2个)和M(8个中的8个)标本中均为100%。将NFM和ATY视为负面结果，将SFM和M视为正面结果，总的来说,卵巢囊肿液细胞学检查的敏感性为45.4%,特异性为100%。
结论：作为一种不常见的测试，卵巢囊性液细胞学检查具有中等敏感性和高特异性。尽管有局限性,卵巢囊性FNA细胞学在某些方面仍然是有价值的诊断工具.
方法：回顾性分析2013-2023年507例卵巢囊肿FNA病例。通过电子数据库收集患者的人口统计学以及临床和放射学信息。以相应的手术病理诊断为金标准计算表现。
结果：总体而言，细胞学诊断为非诊断性（ND），恶性肿瘤（NFM）阴性，非典型(ATY)，可疑恶性肿瘤（SFM），恶性（M）5（1.0%），478（94.3%），14（2.7%），2（0.4%），和8例(1.6%)，分别。在349例（68.8%）有相应手术病理的标本中，在NFM中，恶性肿瘤（包括交界性肿瘤）的发生率为1.2％（325个中的4个），ATY中的72.7%(11个中的8个)，在SFM(2个中的2个)和M(8个中的8个)标本中均为100%。将NFM和ATY视为负面结果，将SFM和M视为正面结果，总的来说,卵巢囊肿液细胞学检查的敏感性为45.4%,特异性为100%。
结论：作为一种不常见的测试，卵巢囊性液细胞学检查具有中等敏感性和高特异性。尽管有局限性,卵巢囊性FNA细胞学在某些方面仍然是有价值的诊断工具.
