Department of Pathology, Queen Alexandra Hospital, Portsmouth, United Kingdom.
Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal.
Cancer Cytopathol. 2021 Jan;129(1):16-21. doi: 10.1002/cncy.22322. Epub 2020 Jul 10.
In diagnostic cytology, the known site-specific false positive rates at various anatomical sites for the risk malignancy (ROM) when a confirmed malignant diagnosis is made are comparatively well documented. ROM figures for diagnostic cytology specimens may vary according to the anatomical site of the specimen, the exact nature of the specimen received, the staining method(s) used, and the use of additional laboratory techniques including molecular profiling; furthermore, they often differ to some extent from institution to institution, between differing cytologists within the same institution, and over time. A brief literature review for a selected group of routine diagnostic cytology specimens shows a published ROM for a confirmed malignant diagnosis as follows: bile duct brushings, ~99% (range, 97%-100%); breast fine needle aspiration, 98.5% (range, 92%-100%); serous effusion fluid, 98.9% (range, 90%-100% although lower for squamous cell carcinoma, mesothelioma, and lymphoma), pulmonary endobronchial ultrasound cytology, ~99% (range, 86.6%-100%); thyroid FNA, 98% (range, 97%-99% if NIFTP tumors are excluded), salivary gland FNA, ~90%; (range 57%-100%) and lateral neck cyst FNA, ~99% (range, 95.5%-100%). Because most diagnostic cytology specimens have a small but accepted false-positive rate, this information is vitally important for the clinical management of patients and for shared patient decision making. In our view, the known false-positive rate for a given diagnostic cytology specimen could be included within the cytology report to assist in explaining the limitations of the diagnostic cytology interpretation and help facilitate the clinical decision-making process.
在诊断细胞学中，对于已确诊的恶性肿瘤（ROM），已知在不同解剖部位的特定部位假阳性率相对较高。诊断细胞学标本的 ROM 数据可能因标本的解剖部位、收到的标本的确切性质、使用的染色方法以及使用包括分子分析在内的其他实验室技术而有所不同；此外，它们通常在不同机构之间、同一机构内不同细胞学专家之间以及随时间推移而有所不同。对一组选定的常规诊断细胞学标本进行的文献综述显示，确诊恶性肿瘤的发表 ROM 如下：胆管刷检，99%（范围，97%-100%）；乳腺细针抽吸，98.5%（范围，92%-100%）；浆膜腔积液，98.9%（范围，90%-100%，但鳞状细胞癌、间皮瘤和淋巴瘤较低），经支气管超声内镜细胞学，99%（范围，86.6%-100%）；甲状腺细针抽吸，98%（范围，97%-99%，如果排除 NIFTP 肿瘤），唾液腺细针抽吸，90%（范围 57%-100%），颈侧囊 FNA，99%（范围，95.5%-100%）。由于大多数诊断细胞学标本的假阳性率较小但可接受，因此这些信息对患者的临床管理和患者共同决策至关重要。在我们看来，给定诊断细胞学标本的已知假阳性率可以包含在细胞学报告中，以协助解释诊断细胞学解释的局限性，并帮助促进临床决策过程。
