利用最近提出的横滨国际协会乳腺细胞学报告系统（IAC Yokohama system）对 512 例乳腺细针抽吸细胞学进行回顾性分析。

A retrospective analysis of 512 cases of breast fine needle aspiration cytology utilizing the recently proposed IAC Yokohama system for reporting breast cytopathology.

机构信息

Department of Pathology, Indira Gandhi ESI Hospital, Delhi, India.

Department of Urology, Indraprashtha Apollo Hospital, Delhi, India.

出版信息

Diagn Cytopathol. 2021 Sep;49(9):1022-1031. doi: 10.1002/dc.24808. Epub 2021 Jun 16.

DOI:10.1002/dc.24808

PMID:34133084

Abstract

BACKGROUND

Recently the International Academy of Cytology (IAC) introduced a new reporting system for breast fine-needle aspiration cytology that classifies cytologic diagnoses into five-categories: (I) insufficient material, (II) benign, (III) atypical, (IV) suspicious of malignancy, and (V) malignant. The current study was undertaken to categorize the breast lesions utilizing the newly proposed IAC Yokohama classification system and evaluate the risk of malignancy (ROM) for respective categories and the diagnostic yield of this technique.

METHODS

All FNAs of breast lesions over 2.5 years were categorized retrospectively using the newly proposed IAC Yokohama reporting system. The ROM was calculated along with sensitivity, specificity, positive and negative predictive value, diagnostic accuracy, false positive, and false-negative rate using the histological diagnosis as the gold standard.

RESULTS

The 512 cases were distributed as follows: Category I (insufficient material) 7.4%, Category II (benign) 74%, Category III (atypical) 5.7%, Category IV(suspicious) 1.4%, and Category V (malignant) 11.5%. Histopathological correlation was available in 285 (55.7%) cases. The respective ROM calculated was 33.3%, 0.5%, 13.3%, 83.3%, and 100% for Category I-V. The Sensitivity, Specificity, Positive and Negative Predictive Value, and Diagnostic accuracy were 95%, 99.5%, 98.27%, 98.6, and 98.5% respectively.

CONCLUSIONS

Despite previous attempts to establish a standardized diagnostic terminology, there has been a lack of a single internationally approved standardized reporting system allowing substantial diagnostic clarity and incorporating distinct diagnostic categories, each linked with a specific ROM and recommended management. This System also provides enhanced communication between pathologists and attending clinicians for the benefit of the patient.

摘要

背景

最近国际细胞学学会（IAC）引入了一种新的乳腺细针抽吸细胞学报告系统，将细胞学诊断分为五类：（I）标本不足，（II）良性，（III）非典型，（IV）疑似恶性，和（V）恶性。本研究旨在利用新提出的 IAC 横滨分类系统对乳腺病变进行分类，并评估各分类的恶性风险（ROM）和该技术的诊断率。

方法

对 2.5 年以上的所有乳腺细针抽吸标本进行回顾性分类，采用新提出的 IAC 横滨报告系统。以组织学诊断为金标准，计算 ROM 以及敏感性、特异性、阳性和阴性预测值、诊断准确性、假阳性和假阴性率。

结果

512 例病例分布如下：I 类（标本不足）7.4%，II 类（良性）74%，III 类（非典型）5.7%，IV 类（可疑）1.4%，V 类（恶性）11.5%。有 285 例（55.7%）病例有组织学相关性。计算出的相应 ROM 分别为 I-V 类的 33.3%、0.5%、13.3%、83.3%和 100%。敏感性、特异性、阳性和阴性预测值、诊断准确性分别为 95%、99.5%、98.27%、98.6%和 98.5%。