Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, India.
Acta Cytol. 2023;67(4):365-377. doi: 10.1159/000530038. Epub 2023 Mar 14.
Fine needle aspiration biopsy (FNAB) is a routinely used investigation in the evaluation of lymph node pathologies. However, there exists a lack of uniformity in cytopathology reporting owing to the nonavailability of standard guidelines. Recently, a novel system for reporting lymph node cytopathology has been proposed. The present study aimed to analyze the utility of the proposed system in cytopathology reporting in our institution.
FNABs of lymph nodes performed over a period of 5 years were categorized as per the proposed Sydney system. The diagnoses on cytopathology were correlated with histopathologic diagnoses to assess the diagnostic accuracy. The rate of malignancy (ROM) for each category was calculated.
A total of 747 lymph node FNABs were included in the study. Histopathology was available in 262 cases. ROM in categories I-V was 26.3%, 7.2%, 76.9%, 82.3%, and 100.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent benign cytopathology were 84.2%, 97.5%, 97.1%, and 86.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent malignant cytopathology were 92.56%, 95.08%, 94.9%, and 92.8%, respectively.
The study substantiates the usefulness of the proposed Sydney system in lymph node cytopathology in enhancing better communication between clinicians and cytopathologists. The use of ancillary techniques like immunocytochemistry and flow cytometry will aid in arriving at a more precise diagnosis.
细针抽吸活检（FNAB）是评估淋巴结病理的常用检查方法。然而，由于缺乏标准指南，细胞病理学报告存在不一致性。最近，提出了一种新的淋巴结细胞病理学报告系统。本研究旨在分析该系统在我院细胞病理学报告中的应用价值。
对 5 年内进行的淋巴结 FNAB 进行分类，依据提出的悉尼系统进行分类。将细胞学诊断与组织病理学诊断进行相关性分析，以评估诊断准确性。计算每个分类的恶性肿瘤率（ROM）。
本研究共纳入 747 例淋巴结 FNAB，其中 262 例有组织病理学结果。分类 I-V 的 ROM 分别为 26.3%、7.2%、76.9%、82.3%和 100.0%。当考虑分类 L3 代表良性细胞学时，FNAB 的敏感性、特异性、阳性预测值和阴性预测值分别为 84.2%、97.5%、97.1%和 86.2%。当考虑分类 L3 代表恶性细胞学时，FNAB 的敏感性、特异性、阳性预测值和阴性预测值分别为 92.56%、95.08%、94.9%和 92.8%。
该研究证实了提出的悉尼系统在淋巴结细胞病理学中的应用价值，该系统可增强临床医生和细胞病理学家之间的更好沟通。辅助技术如免疫细胞化学和流式细胞术的应用将有助于更准确地诊断。
