背景:国际细胞学学会和美国细胞病理学学会最近提出了国际浆液性细胞病理学报告系统(ISRSFC),以规范浆液性细胞病理学报告并指导进一步的临床管理。本研究旨在评估利用ISRSFC报告类别治疗浆液的可行性,估计每个类别的恶性肿瘤(ROM)风险,并仔细检查我们机构遵循的管理协议是否符合ISRFSFC的建议。
方法:所有胸膜,腹膜,并检索了2021年1月至2021年12月间在我们研究所提交评估的心包积液.对所有这些病例进行了审查,并将其重新分类为ISRSFC提议的五类之一:非诊断(ND),恶性肿瘤(NFM)阴性,不确定意义的非典型性(AUS),可疑恶性肿瘤(SFM),恶性(MAL),并计算每个类别的ROM。
结果:本研究检查了596例浆液性积液,其中229例为胸腔积液,358例腹膜积液,其余9例为心包积液。在596例病例中,395例进行了放射学或组织学随访。浆液性积液样本被重新分类为61(10.2%)ND,449(75.3%)NFM,47(7.8%)AUS,17(2.9%)SFM,和22(3.8%)《仲裁示范法》,以上每个类别的ROM为10%,4.4%,19%,83.3%,100%,分别。
结论:根据ISRSFC诊断类别对浆液性积液细胞学样本进行分类可减少报告变异性。ISRSFC提供了预测ROM的标准化格式,从而提高了临床护理的质量。
BACKGROUND: The International Academy of Cytology and the American Society of Cytopathology recently proposed the International System for Reporting Serous Fluid Cytology (ISRSFC) to standardize serous fluid cytopathology reporting and guide further clinical management. The current study aimed to assess the feasibility of utilizing ISRSFC reporting categories for serous fluids, estimate the risk of malignancy (ROM) of each category, and scrutinize if the management protocols followed in our institution are as per the ISRFSFC recommendations.
METHODS: All pleural, peritoneal, and pericardial effusions submitted for evaluation at our institute between January 2021 and December 2021 were retrieved. All these cases were reviewed and re-categorized into one of the five categories proposed by the ISRSFC: non-diagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspicious for malignancy (SFM), and malignant (MAL), and ROM was calculated for each category.
RESULTS: The present study examined 596 serous effusions, of which 229 were pleural effusions, 358 were peritoneal effusions, and the remaining nine were pericardial effusions. Among 596 cases, 395 cases had a radiological or histological follow-up. The serous effusion samples were re-categorized as 61 (10.2%) ND, 449 (75.3%) NFM, 47 (7.8%) AUS, 17 (2.9%) SFM, and 22 (3.8%) MAL, and ROM for each above category were 10%, 4.4%, 19%, 83.3%, and 100%, respectively.
CONCLUSIONS: Categorizing serous effusion cytology samples per the ISRSFC diagnostic categories reduces reporting variability. The ISRSFC provides a standardized format to predict the ROM and thus improves the quality of clinical care.