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Abe H, Kawahara A, Akiba J, Yamaguchi R. Advances in diagnostic liquid-based cytology. Cytopathology 2024. [PMID: 38837293 DOI: 10.1111/cyt.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
Liquid-based cytology (LBC) has changed the landscape of gynaecological cytology. A growing demand exists for LBC in diagnostic cytology, particularly for ancillary testing, such as immunocytochemistry and molecular testing. Ancillary testing solely based on conventional preparation (CP) methods remains challenging. Recently, the increased demand for specialist testing and minimally invasive techniques, such as endoscopic ultrasonography fine-needle aspiration, to obtain cellular samples has led to an increasing demand for ancillary testing on cytology LBC supernatant, slides and cell block (CB). This facilitates the diagnosis and prognosis in cytology samples enabling personalized treatment. An understanding of the history and future prospects of LBC is crucial for its application in routine diagnostics by cytopathologists and cytotechnologists. In this review, we initiated an internet search using the keyword 'liquid-based cytology', and we conducted a literature review to discuss the usefulness of combined diagnosis of LBC and CP, immunocytochemistry and molecular testing and assessed the quality of nucleic acids in diagnostic LBC. High-quality and cell-rich diagnostic LBC surpassed the CP method alone in terms of reliability and versatility of ancillary testing in cytological diagnosis. Conclusively, diagnostic LBC lends itself to various new technologies and is expected to continue evolving with innovations in the future.
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Affiliation(s)
- Hideyuki Abe
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Rin Yamaguchi
- Department of Diagnostic Pathology, Nagasaki University Hospital, Nagasaki, Japan
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Kang YJ, Lee HW, Stybayeva G, Hwang SH. Comparison of Liquid-Based Preparations with Conventional Smears in Thyroid Fine-Needle Aspirates: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:751. [PMID: 38398142 PMCID: PMC10886914 DOI: 10.3390/cancers16040751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND To compare conventional smears (CSs) and liquid-based preparations (LBPs) for diagnosing thyroid malignant or suspicious lesions. METHODS Studies in the PubMed, SCOPUS, Embase, Web of Science, and Cochrane database published up to December 2023. We reviewed 17 studies, including 15,861 samples. RESULTS The diagnostic odds ratio (DOR) for CS was 23.6674. The area under the summary receiver operating characteristic curve (AUC) was 0.879, with sensitivity, specificity, negative predictive value, and positive predictive value of 0.8266, 0.8668, 0.8969, and 0.7841, respectively. The rate of inadequate specimens was 0.1280. For LBP, the DOR was 25.3587, with an AUC of 0.865. The sensitivity, specificity, negative predictive value, and positive predictive value were 0.8190, 0.8833, 0.8515, and 0.8562. The rate of inadequate specimens was 0.1729. For CS plus LBP, the AUC was 0.813, with a lower DOR of 9.4557 compared to individual methods. Diagnostic accuracy did not significantly differ among CS, LBP, and CS plus LBP. Subgroup analysis was used to compare ThinPrep and SurePath. The DORs were 29.1494 and 19.7734. SurePath had a significantly higher AUC. CONCLUSIONS There was no significant difference in diagnostic accuracy or proportion of inadequate smears between CS and LBP. SurePath demonstrated higher diagnostic accuracy than ThinPrep. Recommendations for fine-needle aspiration cytology should consider cost, feasibility, and accuracy.
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Affiliation(s)
- Yun Jin Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan 14584, Republic of Korea; (Y.J.K.); (H.W.L.)
| | - Hyeon Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan 14584, Republic of Korea; (Y.J.K.); (H.W.L.)
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA;
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Fu Y, Sun Y, Pei Q, Han X, Qin W, Mei F, Tan S, Cui L. Factors Influencing the Sample Adequacy of Ultrasound-Guided Fine-Needle Aspiration from Solid Thyroid Nodules for Liquid-Based Cytology: A Demographic, Sonographic, and Technical Perspective. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111639. [PMID: 36422179 PMCID: PMC9698410 DOI: 10.3390/medicina58111639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: To identify factors that influence the sample adequacy of solid thyroid nodules based on ultrasound-guided fine-needle aspiration (FNA) with subsequent liquid-based cytology. Materials and Methods: We retrospectively reviewed 855 patients who underwent ultrasound-guided FNA at our hospital between July 2019 and July 2020. The final analysis included 801 solid thyroid nodules in 801 patients. After reviewing the demographic data, ultrasonic features, and FNA technique-related factors, we defined 14 potential variables. For cytological results, the Bethesda categories II−VI were defined as adequate sample results. Univariate and multivariate analyses were performed to identify factors that influenced sample adequacy. Results: The adequate sample rate was 87.1%. The univariate analysis showed that four factors were related to adequate sampling in patients with thyroid FNA. These factors included age (p < 0.001), nodule orientation (p = 0.0232), calcification (p = 0.0034), and operator experience (p = 0.0286). After the multivariate analysis, five independent factors were identified to improve the diagnostic results of FNA for solid thyroid nodules: (1) the presence of Hashimoto’s thyroiditis (odds ratio (OR) = 1.810; 95% confidence interval (CI): 1.076−3.045; p = 0.0254), (2) a taller-than-wide orientation (OR = 2.038; 95% CI: 1.260−3.296; p = 0.0037), (3) the presence of calcification (OR = 1.767; 95% CI: 1.115−2.799; p = 0.0153), (4) four needle passes to obtain material (OR = 1.750; 95% CI: 1.094−2.799; p = 0.0196), and (5) an experienced operator (OR = 0.561; 95% CI: 0.319−0.987; p = 0.0451). Conclusions: A taller-than-wide orientation, the presence of calcification, and the presence of Hashimoto’s thyroiditis were found to affect the sample adequacy of ultrasound-guided FNA with liquid-based cytology. The sample adequacy could be improved when FNA is performed with four needle passes by experienced doctors.
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Affiliation(s)
- Ying Fu
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Yan Sun
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Qianqian Pei
- Department of Ultrasound, Tongxiang First People’s Hospital, Tongxiang 314500, China
| | - Xiaobo Han
- Department of Ultrasound, Qinhuangdao Third Hospital, Qinhuangdao 066000, China
| | - Wen Qin
- Department of Ultrasound, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, China
| | - Fang Mei
- Department of Pathology, Peking University Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Shi Tan
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
- Correspondence: ; Tel.: +86-13263493931
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Evaluation of Thyroid Fine-Needle Aspiration Biopsies according to Cytological Methods and Comparison with Histopathological Diagnosis. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:93-100. [PMID: 33935542 PMCID: PMC8085446 DOI: 10.14744/semb.2020.94752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
Objectives: In this study, we aim to compare the results of aspiration of thyroid nodules evaluated according to the Bethesda category (BC) with tissue diagnoses in the operation materials and to compare the sensitivity, specificity and accuracy rates according to cytology methods. Methods: The previous fine-needle aspiration biopsy (FNAB) of thyroid nodules of 879 cases diagnosed histopathologically between 2010 and 2017 was examined. The FNAB results determined according to the Bethesda system were matched with tissue diagnoses, sensitivity, specificity, and accuracy rates were investigated according to cytology methods. Results: Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and accuracy rates were found in all FNAB results (in units of %; Sensitivity; 84.7, Specificity; 81.1, PPV; 74.1, NPV; 89.2, Accuracy; 82.5). All of the cytological evaluation methods of thyroid FNABs were found to be reliable and effective (Generally, the results are 80% and above). Specificity and accuracy rates were close to the general average (82.5%) in all methods. However, in cases evaluated with liquid base cytology (LBC) method and in addition to LBC or conventional smear (CS), the sensitivity rates in cases where cell block (CB) were evaluated together were higher than cases in which LBC and CS were used alone (92.6% and 91.0%). When examined statistically, there was no significant difference concerning sensitivity, specificity and accuracy rates of cytological methods (p>0.05, respectively, p=0.576, 0.065, 0.643). Conclusion: In cytopathology, when evaluating thyroid aspirations, it is seen that the LBC method is used instead of CS. In our study, we recommend the use of the LBC method, which seems to have the highest sensitivity (taking into account its technical advantages), instead of CS. However, we think that both CS and LBC methods should be evaluated by supporting them with cell block sections.
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Ahn SH. Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors. Clin Exp Otorhinolaryngol 2020; 14:116-130. [PMID: 32550723 PMCID: PMC7904437 DOI: 10.21053/ceo.2020.00199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/19/2020] [Indexed: 11/25/2022] Open
Abstract
Objectives The usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors. Methods A meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed. Results CNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur. Conclusion A reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.
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Affiliation(s)
- Soon-Hyun Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Wang J, Zhu Y, Song Y, Xu G, Yu H, Wang T, Zhang B. Determining whether surgeons perform thyroid fine-needle aspiration as well as radiologists: an analysis of the adequacy and efficiency of ultrasound-guided fine-needle aspiration performed by newly trained head and neck surgeons and radiologists. Gland Surg 2020; 9:711-720. [PMID: 32775261 DOI: 10.21037/gs.2020.03.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Ultrasound-guided fine-needle aspiration (FNA) cytology is a crucial diagnostic technique used to assess thyroid nodules. In the past, ultrasound-guided FNA was performed mainly by radiologists. However, many surgeons are increasingly being trained for this procedure now. In this study, we aimed to compare the adequacy and efficiency of ultrasound-guided FNA performed by newly trained head and neck surgeons with experienced radiologists in a single institution. We also assessed the malignancy rates in nondiagnostic nodules and the differences between benign and malignant nodules. Methods This is a retrospective study. The data from patients who underwent ultrasound-guided FNA performed by surgeons or radiologists in two consecutive years were collected. Medical records, cytology results, and surgical pathology results were analyzed. Results During the study period, a total of 2,405 ultrasound-guided FNAs were performed on 2,163 patients. The head and neck surgeons and radiologists performed 1,132 and 1,273 ultrasound-guided FNA procedures, respectively. The nondiagnostic rate was 14.49% for surgeons and 15.40% for radiologists (P=0.533). There were no differences in patient age, gender, nodule size, and other sonographic characteristics between the groups of patients who were treated by radiologists versus surgeons. The median waiting time from biopsy appointment to performing ultrasound-guided FNA was 0 days for head and neck surgeons, and 6 days for radiologists (P<0.001). Of the 40 patients who had a repeat FNA or surgery, 19 (47.50%) had a malignancy. Preoperative information about age, gender, operator, and characteristics of nodules did not predict the outcome of nodules with Bethesda category I. Conclusions The adequacy of ultrasound-guided FNAs performed by head and neck surgeons is similar to that of skilled radiologists, while surgeons are more efficient than radiologists. Nondiagnostic FNA reports should not be considered benign, and repeat FNA or selective surgical treatment is recommended.
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Affiliation(s)
- Jiaxin Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yanli Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yuntao Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Guohui Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Hao Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Tianxiao Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Bin Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Mais DD, Crothers BA, Davey DD, Natale KE, Nayar R, Souers RJ, Blond BJ, Hackman S, Tworek JA. Trends in Thyroid Fine-Needle Aspiration Cytology Practices: Results From a College of American Pathologists 2016 Practice Survey. Arch Pathol Lab Med 2019; 143:1364-1372. [PMID: 31100017 DOI: 10.5858/arpa.2018-0429-cp] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The College of American Pathologists periodically surveys laboratories to determine changes in cytopathology practices. We report the results of a 2016 survey concerning thyroid fine-needle aspiration (FNA). OBJECTIVE.— To provide a cross-sectional survey of thyroid cytology practices in 2016. DESIGN.— In 2016, a survey was sent to 2013 laboratories participating in the College of American Pathologists Non-Gynecologic Cytology Education Program (NGC-A) requesting data from 2015-2016 on several topics relating to thyroid FNA. RESULTS.— A total of 878 laboratories (43.6% of 2013) replied to the survey. Radiologists performed the most thyroid FNA procedures in most laboratories (70%; 529 of 756), followed by endocrinologists (18.7%; 141 of 756), and most of these were performed under ultrasound guidance (92.1%; 699 of 759). A total of 32.6% of respondents (251 of 769) provided feedback on unsatisfactory rates for nonpathology providers who performed FNA. Intraprocedural adequacy assessment was primarily performed by attending pathologists (77.4%; 490 of 633) or cytotechnologists (28.4%; 180 of 633). Most laboratories used the Bethesda System for Reporting Thyroid Cytopathology (89.8%; 701 of 781) and performed molecular testing based on clinician request (68.1%; 184 of 270) rather than FNA diagnosis. Correlation of thyroid excisions with prior cytology results most often occurred retrospectively (38.4%; 283 of 737) and was used for pathologist interpretive quality assurance purposes. CONCLUSIONS.— These survey results offer a snapshot of national thyroid FNA cytology practices in 2016 and indicate that standardized cytology terminology is commonly used; pathologists perform most immediate adequacy assessments for thyroid FNA; laboratories use correlation statistics to evaluate pathologists' performance; and molecular tests are increasingly requested for indeterminate interpretations, but reflex molecular testing is rare.
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Affiliation(s)
- Daniel D Mais
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Barbara A Crothers
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Diane Davis Davey
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Kristen E Natale
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Ritu Nayar
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Rhona J Souers
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Barbara J Blond
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Sarah Hackman
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Joseph A Tworek
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
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Ke J, Jianyong L, Ying L, Genpeng L, Linlin S, Zhihui L, Jinnan L, Xueying S, Yong J, Jingqiang Z. The use of The Bethesda System for Reporting Thyroid Cytopathology in a Chinese population: An analysis of 13 351 specimens. Diagn Cytopathol 2019; 47:876-880. [PMID: 31074206 DOI: 10.1002/dc.24207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 03/12/2019] [Accepted: 04/22/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Jiang Ke
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Lei Jianyong
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Liu Ying
- Department of Laboratory Medicine; West China Hospital of Sichuan University; Chengdu China
| | - Li Genpeng
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Song Linlin
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Li Zhihui
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Li Jinnan
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Su Xueying
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Jiang Yong
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Zhu Jingqiang
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
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9
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Itonaga M, Murata SI, Hatamaru K, Tamura T, Nuta J, Kawaji Y, Maekita T, Iguchi M, Kato J, Kojima F, Yamaue H, Kawai M, Okada KI, Hirono S, Shimokawa T, Tanioka K, Kitano M. Diagnostic efficacy of smear plus liquid-based cytology for EUS-FNA of solid pancreatic lesions: A propensity-matched study. Medicine (Baltimore) 2019; 98:e15575. [PMID: 31083233 PMCID: PMC6531231 DOI: 10.1097/md.0000000000015575] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Liquid-based cytology (LBC) is a thin-layer slide preparation procedure that was developed to overcome the cell crowding and contamination associated with smear cytology (SC). The present study compared diagnostic efficacy between SC alone and SC combined with LBC (SLBC) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples of pancreatic lesions.We retrospectively analyzed data derived from 311 consecutive patients. Specimens obtained via EUS-FNA from 179 patients between December 2011 and May 2016 were analyzed by SC, and those obtained from 132 patients between June 2016 and October 2017 were analyzed by SLBC. The 2 groups were compared in terms of adequate sample rate, diagnostic accuracy, sensitivity, and specificity using propensity score matching.SC and SLBC were compared using propensity score-matching in 204 patients (n = 102 per group). The adequate sample rate did not differ significantly between SLBC (100%) and SC (99.0%, P = 1). Diagnostic sensitivity, negative predictive value and accuracy were better for SLBC than for SC in terms of cytological (93.2% vs 67.4%, 68.4% vs 23.1%, and 94.1% vs 69.6%, P < .01 each, respectively) and cytohistological (95.5% vs 81.5%, 76.5% vs 34.6%, and 96.1% vs 82.4%, P < .01, P = .02, and P < .01, respectively) analyses.SLBC improves the diagnostic efficacy of EUS-FNA for pancreatic lesions compared to LBC.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jun Kato
- Second Department of Internal Medicine
| | | | | | | | | | | | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan
| | - Kensuke Tanioka
- Clinical Study Support Center, Wakayama Medical University, Wakayama, Japan
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Clinical Parameter for Deciding the BRAFV600E Mutation Test in Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Thyroid Nodules: US Features According to TIRADS. Ultrasound Q 2018; 33:284-288. [PMID: 28877096 DOI: 10.1097/ruq.0000000000000313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the usefulness of a thyroid imaging reporting and data system (TIRADS) to select thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) cytology for additional BRAF mutation testing. Three hundred three thyroid nodules were included. Statistical analysis was performed at both patient and nodule levels according to BRAF mutation positivity and clinical factors. Univariate and multivariate logistic regression analyses were performed to assess independent associations between BRAF mutation positivity and clinical factors. Of 303 AUS/FLUS nodules, 16 (5.3%) of 303 nodules had the BRAF mutation. The frequency of the BRAF mutation according to the TIRADS was 35.7% for category 5, 10.8% for category 4c, 2.5% for category 4b, 1.1% for category 4a, and 0% for category 3 nodules (P < 0.001). On multivariate analysis, BRAF mutation positivity was significantly associated with high suspicion on the TIRADS (odds ratio, 15.247; P < 0.001). In conclusion, the ultrasonography patterns of the TIRADS can be used as a clinical parameter for deciding the BRAF mutation test in thyroid nodules with AUS/FLUS cytology.
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11
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Jiang K, Zhou J, Lei J, Liu Y, Li J, Su X, Li Z, Wei T, Jiang Y, Zhu J. Cell block is a valuable adjunct to conventional smear for thyroid fine needle aspiration: 2395 cases with histological correlation. Cytopathology 2018; 29:525-530. [PMID: 30238537 DOI: 10.1111/cyt.12633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/03/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Ke Jiang
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Junyi Zhou
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Jianyong Lei
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Ying Liu
- Department of Laboratory Medicine; West China Hospital of Sichuan University; Chengdu China
| | - Jinnan Li
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Xueying Su
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Tao Wei
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Yong Jiang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Jingqiang Zhu
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
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Bode-Lesniewska B, Cochand-Priollet B, Straccia P, Fadda G, Bongiovanni M. Management of thyroid cytological material, preanalytical procedures and bio-banking. Cytopathology 2018; 30:7-16. [DOI: 10.1111/cyt.12586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 12/29/2022]
Affiliation(s)
- B. Bode-Lesniewska
- Institute of Pathology and Molecular Pathology; University Hospital Zurich; Zurich Switzerland
| | - B. Cochand-Priollet
- Department of Pathology; Faculté Paris Descartes; Cochin Hospital; APHP; Paris France
| | - P. Straccia
- Division of Anatomic Pathology and Histology; Catholic University of Sacred Heart; Foundation “Agostino Gemelli” University Hospital; Rome Italy
| | - G. Fadda
- Division of Anatomic Pathology and Histology; Catholic University of Sacred Heart; Foundation “Agostino Gemelli” University Hospital; Rome Italy
| | - M. Bongiovanni
- Service of Clinical Pathology; Institute of Pathology; Lausanne University Hospital; Lausanne Switzerland
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Viswanathan K, Sung SJ, Scognamiglio T, Hoda RS, Rao RA. Fine needle aspiration of pilomatrixoma: Cytologic features on thinprep and diagnostic pitfalls. Diagn Cytopathol 2018; 46:452-455. [PMID: 29464894 DOI: 10.1002/dc.23909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 01/07/2018] [Accepted: 02/06/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Kartik Viswanathan
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Simon J Sung
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Theresa Scognamiglio
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Rana S Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Rema A Rao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
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Validation of the 2015 American Thyroid Association Management Guidelines for Thyroid Nodules With Benign Cytologic Findings in the Era of the Bethesda System. AJR Am J Roentgenol 2018; 210:629-634. [PMID: 29323546 DOI: 10.2214/ajr.17.18507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The purpose of this study is to investigate follow-up strategies for cytologically benign thyroid nodules according to size and ultrasound (US) pattern according to the 2015 American Thyroid Association (ATA) guidelines in the era of the Bethesda system. MATERIALS AND METHODS This retrospective study included 1208 patients with 1230 nodules that were cytologically benign at initial fine-needle aspiration performed from June 2012 to December 2014. False-negative rates (FNRs) were calculated by considering nodule size and US pattern according to the 2015 ATA guidelines and were compared between nodules with the high-suspicion US pattern and nodules with the high- or intermediate-suspicion US patterns according to size. RESULTS Twenty-five of the 1230 nodules (2.0%) were malignant. The FNRs were 5.1% (8/158) for nodules with the high-suspicion US pattern and 1.6% (17/1072) for nodules with other US patterns. With regard to nodule size, the FNRs were 3.2% (9/277) for nodules 3 cm or larger and 5.2% (6/115) for nodules 4 cm or larger. The FNRs of nodules with the high-suspicion pattern were not significantly higher than those of nodules with the high- or intermediate-suspicion patterns among nodules 2 cm or larger (2.5% vs 1.9%; p = 0.208), 3 cm or larger (3.4% vs 2.9%; p = 0.498), and 4 cm or larger (5.4% vs 3.8%; p = 0.353). CONCLUSION Thyroid nodules with initial benign cytologic findings had a low malignancy rate in the era of the Bethesda system, regardless of US pattern and size. Therefore, any immediate diagnostic intervention may be discouraged in cytologically benign nodules.
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Viswanathan K, Sung S, Facey KT, Alperstein SA, Pisapia DJ, Rao RA, Hoda RS. Fine needle aspiration of meningioma: Cytologic features on ThinPrep. Diagn Cytopathol 2017; 46:98-100. [PMID: 29024513 DOI: 10.1002/dc.23832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/03/2017] [Accepted: 09/27/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Kartik Viswanathan
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Simon Sung
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Kirk T Facey
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Susan A Alperstein
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - David J Pisapia
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Rema A Rao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Rana S Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
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Shen Y, Zhang X, Lin W, Wan C, Li Q, Jiang Y. Liquid-based cytopathology test as a novel method to identify Aspergillus in patients with pulmonary aspergillosis. Sci Rep 2017; 7:7528. [PMID: 28790413 PMCID: PMC5548770 DOI: 10.1038/s41598-017-07564-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 06/27/2017] [Indexed: 02/05/2023] Open
Abstract
Conventional cytopathology examination of respiratory samples can aid in identifying Aspergillus but with poor sensitivity, so this study aimed to assess the potential of the liquid-based cytopathology test (LCT) for improving the identification of Aspergillus in respiratory samples following Papanicolaou's or Special staining with Grocott's methenamine silver or periodic acid-Schiff staining. Paired bronchial brushing samples (n = 54) and sputum samples (n = 117) from 171 patients with pulmonary aspergillosis were prepared as slides using either conventional cytopathology or SurePath LCT. LCT slides were generally superior to conventional slides, showing smaller cell monolayer surface area, clearer background and more distinct stereoscopic cytological features. For Papanicolaou's staining, LCT-prepared slides allowed a higher positive rate of Aspergillus identification than conventional slides for bronchial brushing samples (59.25% vs. 20.37%, P < 0.05) and sputum samples (29.05% vs. 8.55%, P < 0.05). Similarly, Special staining of LCT-prepared slides showed a higher positive rate of Aspergillus identification for bronchial brushing samples (83.33% vs. 57.41%, P < 0.05) and sputum samples (43.59% vs. 19.66%, P < 0.05). This preliminary study suggests that LCT may be better than conventional slide preparation for identifying Aspergillus in respiratory samples from patients with pulmonary aspergillosis.
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Affiliation(s)
- Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, 610041, China
| | - Xiaorong Zhang
- Department of Pathology, The First Affiliated Hospital of Jiujiang University, Jiujiang, 332005, China
| | - Wenyi Lin
- Department of Pathology, Chengdu Womens' and Children's Central Hospital, Chengdu, 610091, China
| | - Chun Wan
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, 610041, China
| | - Qiyuan Li
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yong Jiang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, 610041, China.
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