Department of Public Health, University of Naples Federico II, Naples, Italy.
Pathology Department, Jose M. Morales Meseguer University General Hospital, Murcia, Spain.
Cancer Cytopathol. 2020 Dec;128(12):885-894. doi: 10.1002/cncy.22373. Epub 2020 Oct 27.
To the authors' knowledge, the impact of the coronavirus disease 2019 (COVID-19) pandemic on cytopathology practices worldwide has not been investigated formally. In the current study, data from 41 respondents from 23 countries were reported.
Data regarding the activity of each cytopathology laboratory during 4 weeks of COVID-19 lockdown were collected and compared with those obtained during the corresponding period in 2019. The overall number and percentage of exfoliative and fine-needle aspiration cytology samples from each anatomic site were recorded. Differences in the malignancy and suspicious rates between the 2 periods were analyzed using a meta-analytical approach.
Overall, the sample volume was lower compared with 2019 (104,319 samples vs 190,225 samples), with an average volume reduction of 45.3% (range, 0.1%-98.0%). The percentage of samples from the cervicovaginal tract, thyroid, and anorectal region was significantly reduced (P < .05). Conversely, the percentage of samples from the urinary tract, serous cavities, breast, lymph nodes, respiratory tract, salivary glands, central nervous system, gastrointestinal tract, pancreas, liver, and biliary tract increased (P < .05). An overall increase of 5.56% (95% CI, 3.77%-7.35%) in the malignancy rate in nongynecological samples during the COVID-19 pandemic was observed. When the suspicious category was included, the overall increase was 6.95% (95% CI, 4.63%-9.27%).
The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted.
据作者所知，尚未正式调查 2019 年冠状病毒病（COVID-19）大流行对全球细胞病理学实践的影响。在本研究中，报告了来自 23 个国家的 41 名受访者的数据。
收集了 COVID-19 封锁期间每个细胞病理学实验室的活动数据，并与 2019 年同期的数据进行了比较。记录了来自每个解剖部位的脱落细胞和细针抽吸细胞学样本的总数和百分比。使用荟萃分析方法分析了这两个时期恶性肿瘤和可疑率的差异。
总体而言，与 2019 年相比，样本量较低（104319 例与 190225 例），平均减少 45.3%（范围为 0.1%-98.0%）。宫颈阴道、甲状腺和肛肠部位的样本百分比明显减少（P<.05）。相反，来自泌尿道、浆膜腔、乳房、淋巴结、呼吸道、唾液腺、中枢神经系统、胃肠道、胰腺、肝脏和胆道的样本百分比增加（P<.05）。在 COVID-19 大流行期间，非妇科样本的恶性肿瘤率总体上升了 5.56%（95%可信区间，3.77%-7.35%）。当包括可疑类别时，总体增长率为 6.95%（95%可信区间，4.63%-9.27%）。
COVID-19 大流行导致细胞学标本总数急剧减少，无论解剖部位或标本类型如何。恶性肿瘤率增加，反映了被认为有高风险的癌症患者的优先治疗。有必要对封锁期间延迟获得医疗服务的影响进行前瞻性监测。
