Shakthivel V, Ahluwalia Charanjeet, Ahuja Sana, Ranga Sunil
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Diagn Cytopathol. 2025 Jan;53(1):27-34. doi: 10.1002/dc.25405. Epub 2024 Sep 23.
Lung cancer is the leading cause of cancer-related deaths globally, with early diagnosis crucial for improving survival. The 2023 WHO reporting system for lung cytopathology aims to standardize diagnostic criteria. This study assesses the system's diagnostic accuracy.
This retrospective study analyzed 207 respiratory tract cytology samples (bronchoalveolar lavage/bronchial washing and endobronchial ultrasound-guided transbronchial needle aspiration) from January 2023 to June 2024. Samples were classified into five WHO categories: Nondiagnostic, Benign, Atypical, Suspicious for Malignancy, and Malignant. Histological correlation was performed where available. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using histological diagnosis as the reference.
Patients ranged from 27 to 87 years old, with a male-to-female ratio of 5.8:1. Sample distribution: Nondiagnostic (3.4%), Benign (63.7%), Atypical (6.3%), Suspicious for Malignancy (16.9%), and Malignant (9.6%). Histological correlation was available for 46.3% of cases. Risk of malignancy (ROM) was 25% for Nondiagnostic, 25.7% for Benign, 44.4% for Atypical, 93.5% for Suspicious for Malignancy, and 100% for Malignant. Highest sensitivity (84.75%) and NPV (74.29%) were achieved when Atypical, Suspicious for Malignancy, and Malignant categories were considered positive for malignancy.
The 2023 WHO reporting system for lung cytopathology offers a standardized and accurate diagnostic framework, enhancing patient management. Further studies are recommended to validate these results.
肺癌是全球癌症相关死亡的主要原因，早期诊断对提高生存率至关重要。2023年世界卫生组织肺癌细胞病理学报告系统旨在规范诊断标准。本研究评估该系统的诊断准确性。
这项回顾性研究分析了2023年1月至2024年6月期间的207份呼吸道细胞学样本（支气管肺泡灌洗/支气管冲洗和支气管内超声引导下经支气管针吸活检）。样本被分为世界卫生组织的五个类别：无法诊断、良性、非典型、疑似恶性和恶性。如有可用样本，则进行组织学相关性分析。以组织学诊断为参考，计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性。
患者年龄在27至87岁之间，男女比例为5.8:1。样本分布：无法诊断（3.4%）、良性（63.7%）、非典型（6.3%）、疑似恶性（16.9%）和恶性（9.6%）。46.3%的病例有组织学相关性分析。无法诊断样本的恶性风险（ROM）为25%，良性样本为25.7%，非典型样本为44.4%，疑似恶性样本为93.5%，恶性样本为100%。当将非典型、疑似恶性和恶性类别视为恶性阳性时，敏感性最高（84.75%），NPV最高（74.29%）。
2023年世界卫生组织肺癌细胞病理学报告系统提供了一个标准化且准确的诊断框架，有助于改善患者管理。建议进一步开展研究以验证这些结果。
