Serviço de Anatomia Patológica, Centro Hospitalar de Lisboa Ocidental, EPE, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal.
Department of Cellular Pathology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
J Am Soc Cytopathol. 2020 Nov-Dec;9(6):469-477. doi: 10.1016/j.jasc.2020.05.015. Epub 2020 Jun 9.
Effusions can develop inside serous cavities in several pathologic states, both neoplastic and non-neoplastic. They are easy to drain and can provide useful diagnostic information. However, the reported diagnostic efficacy of these specimens has not been uniform across different laboratories. To standardize practices, the international system for reporting serous fluid cytology (TIS) was developed in accordance with the best international practices, the most up-to-date reported data, and expert consensus.
TIS has set the basic principles for laboratory handling of serous effusion specimens, defined the adequacy criteria, and set a standardized reporting terminology with well-defined criteria for each diagnostic category. These include nondiagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, and malignant. Each can provide useful inherent information for appropriate clinical management and follow-up, with a defined expected diagnostic category incidence and risk of malignancy.
TIS applies to serous fluids collected from the pleura, peritoneal, and pericardial cavities. Using TIS, indeterminate categories are presented as either preliminary or as options of last resource. TIS has emphasized the role of ancillary tests in arriving at the correct interpretation within each category. It also has emphasized the importance of a malignant diagnosis as a definitive diagnosis, comparable to histologic examinations. Because of the well-documented outcomes in the adoption of uniform cytology terminology for other organ systems, we recommend the use of the upcoming TIS and believe its use will be paramount to improving the diagnostic yield in this area of cytology.
在多种病理状态下，包括肿瘤性和非肿瘤性状态，浆膜腔内均可发生积液。这些积液易于引流，并能提供有用的诊断信息。然而，不同实验室报道的此类标本的诊断效能并不一致。为了规范操作，国际浆膜腔液细胞学报告系统（TIS）是根据最佳国际实践、最新报道的数据和专家共识制定的。
TIS 为浆膜腔积液标本的实验室处理设定了基本原则，定义了充足性标准，并采用标准化报告术语，为每个诊断类别设定了明确的标准。这些类别包括非诊断性、无恶性肿瘤、意义未明的非典型性、疑似恶性和恶性。每个类别都能为适当的临床管理和随访提供有用的固有信息，并具有明确的预期诊断类别发生率和恶性风险。
TIS 适用于从胸膜、腹膜和心包腔收集的浆膜液。使用 TIS 时，不确定类别可作为初步类别或最后的选择类别呈现。TIS 强调了辅助检查在每个类别中得出正确解释的作用。它还强调了恶性诊断作为明确诊断的重要性，与组织学检查相当。鉴于在其他器官系统采用统一细胞学术语方面有充分记录的结果，我们建议使用即将推出的 TIS，并相信其使用对于提高该领域细胞学的诊断效果至关重要。
