cytology

细胞学
  • 文章类型: Journal Article
    肝内胆管癌(iCCA)是第二常见的恶性原发性肝癌。iCCA可能在潜在的慢性肝病上发展,其发病率与肥胖和代谢性疾病的流行有关。相比之下,肝门部胆管癌(pCCA)可能伴随着胆道慢性炎症性疾病的病史。CCA的初始管理通常很复杂,需要多学科的专业知识。法国肝脏研究协会希望组织指南,以便总结关于iCCA和pCCA几个关键点的最佳证据。这些指南是根据文献中现有的证据水平制定的,并对每项建议进行了分析,由专家小组讨论和投票。他们描述了CCA的流行病学以及从诊断到治疗如何管理iCCA或pCCA患者。还强调了个性化医学和靶向疗法的使用的最新发展。
    Intrahepatic cholangiocarcinoma (iCCA) is the second most common malignant primary liver cancer. iCCA may develop on an underlying chronic liver disease and its incidence is growing in relation with the epidemics of obesity and metabolic diseases. In contrast, perihilar cholangiocarcinoma (pCCA) may follow a history of chronic inflammatory diseases of the biliary tract. The initial management of CCAs is often complex and requires multidisciplinary expertise. The French Association for the Study of the Liver wished to organize guidelines in order to summarize the best evidence available about several key points in iCCA and pCCA. These guidelines have been elaborated based on the level of evidence available in the literature and each recommendation has been analysed, discussed and voted by the panel of experts. They describe the epidemiology of CCA as well as how patients with iCCA or pCCA should be managed from diagnosis to treatment. The most recent developments of personalized medicine and use of targeted therapies are also highlighted.
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  • 文章类型: English Abstract
    SFE-AFCE-SFMN2022共识涉及甲状腺结节的管理,这种症状是内分泌学咨询的常见原因。甲状腺结节非常常见,大多为良性。甲状腺超声和甲状腺细针穿刺活检(FNAB)是分析这些结节的参考测试。本文的目的是为细胞病理学家描述涉及甲状腺细胞学的SFE-AFCE-SFMN2022共识的要点:甲状腺FNAB的适应症,技术和分析,和管理(治疗,随访)在进行细胞学筛查检查后,甲状腺结节管理的关键因素。
    The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a symptom that is a frequent reason for consultation in endocrinology. Thyroid nodules are very common and mostly benign. Thyroid ultrasound and thyroid fine-needle aspiration biopsy (FNAB) are the reference tests for the analysis of these nodules. The aim of this article is to describe for the cytopathologist the key points of the SFE-AFCE-SFMN 2022 consensus involving thyroid cytology: the indications for thyroid FNAB, the technique and analysis, and the management (treatment, follow-up) following this cytological screening examination, a key element in the management of the thyroid nodule.
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  • 文章类型: Systematic Review
    结合2023年日本妇科肿瘤学会子宫内膜癌临床实践指南的更新,对早期子宫内膜癌患者辅助治疗的治疗益处进行了系统评价。腹膜细胞学(PPC)阳性,没有复发的危险因素。系统评价仅包括两项符合条件的回顾性研究。两项研究都包括有复发危险因素的患者。美国的一项全国性研究报道,通过多变量分析,辅助化疗与I-II期PPC子宫内膜癌患者死亡风险降低相关。倾向得分调整分析。日本的另一项单中心研究报告,单变量分析显示IA期子宫内膜癌患者的辅助化疗与无复发生存期之间没有关联。这项系统评价发现,证据有限,结果相互矛盾。需要持续的评估来解决这个临床问题。
    In association with an update of the Japan Society of Gynecologic Oncology clinical practice guidelines for endometrial cancer in 2023, a systematic review was conducted about the therapeutic benefit of adjuvant therapy on patients with early-stage endometrial carcinoma, who presented positive peritoneal cytology (PPC) without the risk factors for recurrence. The systematic review only included two eligible retrospective studies. Both studies included patients with risk factors for recurrence. A nationwide study in the United States reported that adjuvant chemotherapy was associated with the reduced risk of death among patients with stages I-II endometrial cancer with PPC by multivariate, propensity score-adjusted analysis. Another single-center study in Japan reported no association between adjuvant chemotherapy and relapse-free survival among patients with stage IA endometrial cancer by univariate analysis. This systematic review identified that evidence was limited with conflicting results. Continuous evaluation is warranted to address this clinical question.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    癌症药物治疗正在取得快速进展。自从分子靶向治疗被引入,个性化医疗正在实践,在常规实践中获得的恶性肿瘤病理组织经常用于基因组测试。而主要用酒精固定的细胞学标本被认为在核酸质量和数量的保存方面更有利。本文旨在根据日本临床细胞学学会在2021年发表的“癌症基因组医学细胞学标本处理指南(日语)”中建立的发现,分享基因组医学实践中正确处理细胞学标本的信息。由三部分组成的实践指南基于经验数据分析;第1部分描述了在癌症基因组医学中使用细胞学标本的一般评论,然后第2部分描述了细胞学标本的正确处理,第3部分描述了与处理细胞学标本相关的经验数据。指南指出在每次固定中正确处理标本,准备,和评价。
    Rapid advances are being made in cancer drug therapy. Since molecularly targeted therapy has been introduced, personalized medicine is being practiced, pathological tissue from malignant tumors obtained during routine practice is frequently used for genomic testing. Whereas cytological specimens fixed mainly in alcohol are considered to be more advantageous in terms of preservation of the nucleic acid quality and quantity. This article is aimed to share the information for the proper handling of cytological specimens in practice for genomic medicine based on the findings established in \"Guidelines for Handling of Cytological Specimens in Cancer Genomic Medicine (in Japanese)\" published by the Japanese Society of Clinical Cytology in 2021. The three-part practical guidelines are based on empirical data analyses; Part 1 describes general remarks on the use of cytological specimens in cancer genomic medicine, then Part 2 describes proper handling of cytological specimens, and Part 3 describes the empirical data related to handling of cytological specimens. The guidelines indicated proper handling of specimens in each fixation, preparation, and evaluation.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    随着数字化病理切片扫描和人工智能技术的迅速发展,宫颈癌智能辅助筛查有望减轻病理医师的工作量,提升宫颈癌筛查效率。用于宫颈癌智能辅助筛查算法研发的液基制片数据集不可或缺,因此标准化数据集建设迫在眉睫。为解决当前宫颈癌人工智能辅助筛查产品缺乏标准化标注数据集且难以开展规范化质量可控的算法训练和评估问题,中华医学会病理学分会细胞病理学组联合北京大学工学院有关专家经反复讨论,对数据集数据质量、数据采集、数据处理、数据标注等形成共识。.
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  • 文章类型: Practice Guideline
    SFE-AFCE-SFMN2022共识涉及甲状腺结节的管理,这是内分泌学咨询的常见原因。在90%以上的案例中,患者甲状腺功能正常,良性非进展性结节,不需要特殊治疗。临床医生的目标是检测有复发和死亡风险的恶性甲状腺结节,导致甲状腺功能亢进的毒性结节或压缩性结节需要治疗。甲状腺结节的诊断和治疗需要内分泌学家之间的密切合作,核医学医师和外科医生,但也涉及其他专家。因此,这一共识声明是由3个学会共同建立的:法国内分泌学学会(SFE),法国内分泌外科协会(AFCE)和法国核医学学会(SFMN);各个工作组包括来自其他专业的专家(病理学家,放射科医生,儿科医生,生物学家,等。).本节涉及甲状腺细针穿刺活检(FNAB)的技术和解释,甲状腺结节分析的参考测试。
    The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician\'s objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with the technique and interpretation of thyroid fine-needle aspiration biopsy (FNAB), a reference test for the analysis of thyroid nodules.
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  • 文章类型: Journal Article
    猫传染性腹膜炎(FIP)是猫最重要的传染病和死亡原因之一;小于2岁的幼猫尤其容易受到伤害。FIP是由猫冠状病毒(FCoV)引起的。据估计,兽医机构中约有0.3%至1.4%的猫科动物死亡是由FIP引起的。
    本文件由猫科动物临床医学专家工作组开发,作为2022年AAFP/EveryCat猫科动物传染性腹膜炎诊断指南,为兽医提供必要的信息,以帮助他们识别出现FIP的猫。
    几乎每一个小动物兽医都会看到案例。由于缺乏病理临床体征或实验室变化,FIP可能难以诊断。尤其是当没有积液时。对每个诊断测试的灵敏度有很好的了解,特异性,预测值,在建立FIP案例时,似然比和诊断准确性很重要。在进行任何诊断测试或商业实验室简介之前,临床医生应该能够回答以下问题:“为什么要进行这种测试?”和“结果意味着什么?”最终,诊断FIP的方法必须针对单个猫的具体表现进行调整。
    鉴于这种疾病未经治疗是致命的,获得正确诊断的能力至关重要。临床医生必须考虑患者的个人病史,选择诊断测试和样本类型时的信号和全面体检结果,以建立怀疑指数“一砖一瓦”。研究表明,新的抗病毒药物在FIP治疗中的疗效,但是这些产品目前在许多国家都无法合法获得。工作组鼓励兽医审查文献,并随时了解临床试验和新药批准情况。
    Feline infectious peritonitis (FIP) is one of the most important infectious diseases and causes of death in cats; young cats less than 2 years of age are especially vulnerable. FIP is caused by a feline coronavirus (FCoV). It has been estimated that around 0.3% to 1.4% of feline deaths at veterinary institutions are caused by FIP.
    This document has been developed by a Task Force of experts in feline clinical medicine as the 2022 AAFP/EveryCat Feline Infectious Peritonitis Diagnosis Guidelines to provide veterinarians with essential information to aid their ability to recognize cats presenting with FIP.
    Nearly every small animal veterinary practitioner will see cases. FIP can be challenging to diagnose owing to the lack of pathognomonic clinical signs or laboratory changes, especially when no effusion is present. A good understanding of each diagnostic test\'s sensitivity, specificity, predictive value, likelihood ratio and diagnostic accuracy is important when building a case for FIP. Before proceeding with any diagnostic test or commercial laboratory profile, the clinician should be able to answer the questions of \'why this test?\' and \'what do the results mean?\' Ultimately, the approach to diagnosing FIP must be tailored to the specific presentation of the individual cat.
    Given that the disease is fatal when untreated, the ability to obtain a correct diagnosis is critical. The clinician must consider the individual patient\'s history, signalment and comprehensive physical examination findings when selecting diagnostic tests and sample types in order to build the index of suspicion \'brick by brick\'. Research has demonstrated efficacy of new antivirals in FIP treatment, but these products are not legally available in many countries at this time. The Task Force encourages veterinarians to review the literature and stay informed on clinical trials and new drug approvals.
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  • 文章类型: Journal Article
    意大利甲状腺细胞学分类和报告共识(ICCRTC)包括六个诊断类别(TIR1/1C,TIR2,TIR3A,TIR3B,TIR4和TIR5),每种都表明恶性肿瘤的风险不同。这项单中心回顾性研究的目的是评估作者机构中ICCRTC类别的分布并评估其细胞组织学相关性。
    作者回顾性收集了37,371例甲状腺结节的连续细胞学报告,并描述了不同细胞学类别的临床病理特征。在一部分患者中,细胞学诊断也与组织学结果进行了比较。
    细胞学分类分布如下:非诊断性,15.6%;良性,66.5%;低风险不确定,10%(TIR3A);高风险不确定,3.5%(TIR3B);可疑,1.7%;和恶性,2.6%。根据组织学,在非诊断类别中,恶性肿瘤的风险非常高(29.8%),年轻男性患者更容易接触恶性肿瘤,在良性结节(7.8%)和不确定结节中相对较高(TIR3A中为32.5%;TIR3B中为52.1%),主要是因为滤泡结构在恶性肿瘤中的高患病率。在组织学上,可疑和恶性类别的恶性率分别为92.4%和99.3%,分别;在这些类别中,甲状腺乳头状癌的侵袭性变异主要被诊断出来。
    在本系列中,非诊断性结节患病率高,令人惊讶的是,恶性率高。具有滤泡结构的恶性肿瘤代表了良性和不确定结节的诊断陷阱。可疑和恶性类别对恶性肿瘤具有高度特异性。重要的是,ICCRTC在确定甲状腺癌的术前侵袭性组织学类型方面具有很高的可靠性.
    The Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) includes six diagnostic categories (TIR 1/1C, TIR 2, TIR 3A, TIR 3B, TIR 4, and TIR 5), each indicating a different risk of malignancy. The objective of this monocentric retrospective study was to evaluate the distribution of the ICCRTC classes at the authors\' institution and assess their cytohistologic correlations.
    The authors retrospectively collected 37,371 consecutive cytologic reports of thyroid nodules and described the clinical-pathologic features of the different cytologic categories. The cytologic diagnoses also were compared with histologic outcomes in a subset of patients.
    The cytologic classes were distributed as follows: nondiagnostic, 15.6%; benign, 66.5%; low-risk indeterminate, 10% (TIR 3A); high-risk indeterminate, 3.5% (TIR 3B); suspicious, 1.7%; and malignant, 2.6%. According to histology, the risk of malignancy was very high in the nondiagnostic category (29.8%), with young male patients more exposed to malignancy, and it was relatively high among benign (7.8%) and indeterminate nodules (32.5% in TIR 3A; 52.1% in TIR 3B), mainly because of the high prevalence of follicular architecture in malignant tumors. On histology, the malignancy rates were 92.4% and 99.3% for the suspicious and malignant categories, respectively; aggressive variants of papillary thyroid carcinoma were mostly diagnosed in these categories.
    In this series, nondiagnostic nodules showed high prevalence and, surprisingly, high malignancy rates. Malignant tumors with follicular architecture represented a diagnostic pitfall in benign and indeterminate nodules. The suspicious and malignant categories had high specificity for malignancy. Importantly, the ICCRTC had high reliability for identifying preoperatively aggressive histotypes of thyroid carcinoma.
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