Agarwal Akansha, Singh Divya, Mehan Anoushika, Paul Pranoy, Puri Neeti, Gupta Priyanka, Syed Anjum, Rao Shalinee, Chowdhury Nilotpal, Ravi Bina
Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India.
Integrated Breast Care Centre and Department of radiodiagnosis, All India Institute of Medical Sciences, , Rishikesh, India.
Diagn Cytopathol. 2021 Feb;49(2):195-202. doi: 10.1002/dc.24632. Epub 2020 Oct 5.
The International Academy of Cytology (IAC) Yokohama system is a recently proposed system for reporting breast cytology by fine needle aspiration biopsies (FNAB). Multiple studies are needed to confirm the risk of malignancy (ROM) of the various reporting categories of this system. The present article studies the accuracy of the IAC Yokohama system in our center.
Over a period of 1 year (September 2018-August 2019), all cases of breast masses assessed by FNAB and histological correlation were studied retrospectively. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) and overall accuracy of the IAC Yokohama system for diagnosing malignancy were assessed. The rates of malignancy (ROM) of each diagnostic category were also estimated.
Three hundred and twenty-one FNABs had cyto-histological correlation. The percent sensitivity (with 95% Confidence Intervals) when the atypical, suspicious of malignancy and the malignant categories were regarded as positive for malignancy were 98.2% [95.5%, 99.5%], 96.0% [92.5%, 98.2%], and 86.7% [81.5%, 90.8%] respectively. The percent specificity (with 95% Confidence intervals) for the same categories in the same order were 59.5% [47.4%, 70.7%], 91.9% [83.2%, 97.0%], and 100% [95.1%, 100%] respectively. The area under curve (AUC) for diagnosing malignancy was 0.981[0.963, 0.993]. The ROM for the benign, atypical, suspicious of malignancy and malignant category were 8.3% [2.3%, 20.0%], 17.2% [5.8%, 35.8%], 77.8% [57.7%, 91.4%], and 100% [98.1%, 100%] respectively.
The IAC Yokohama system is suitable for accurately reporting breast lesions on FNAB.
国际细胞学会（IAC）横滨系统是最近提出的一种通过细针穿刺活检（FNAB）报告乳腺细胞学的系统。需要多项研究来证实该系统不同报告类别的恶性风险（ROM）。本文研究了IAC横滨系统在我们中心的准确性。
在1年时间内（2018年9月至2019年8月），对所有通过FNAB评估并进行组织学相关性分析的乳腺肿块病例进行回顾性研究。评估了IAC横滨系统诊断恶性肿瘤的敏感性、特异性、阴性预测值（NPV）、阳性预测值（PPV）和总体准确性。还估计了每个诊断类别的恶性率（ROM）。
321例FNAB有细胞-组织学相关性。当将非典型、可疑恶性和恶性类别视为恶性阳性时，敏感性百分比（95%置信区间）分别为98.2% [95.5%，99.5%]、96.0% [92.5%，98.2%]和86.7% [81.5%，90.8%]。相同顺序下相同类别的特异性百分比（95%置信区间）分别为59.5% [47.4%，70.7%]、91.9% [83.2%，97.0%]和100% [95.1%，100%]。诊断恶性肿瘤的曲线下面积（AUC）为0.981 [0.963，0.993]。良性、非典型、可疑恶性和恶性类别的ROM分别为8.3% [2.3%，20.0%]、17.2% [5.8%，35.8%]、77.8% [57.7%，91.4%]和100% [98.1%，100%]。
IAC横滨系统适用于准确报告FNAB上的乳腺病变。
