Köster Jan, De Mattos Camila Bedeschi Rego, Domanski Henryk A
Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden.
Department of Clinical Genetics, Pathology and Molecular Diagnostic, Division of Laboratory Medicine, Lund, Sweden.
Cytopathology. 2025 Mar;36(2):123-139. doi: 10.1111/cyt.13462. Epub 2024 Dec 9.
Fine-needle aspiration cytology (FNAC) from bone lesions has been proven to be a useful diagnostic tool but lacks standardisation. The aim of the study was to evaluate the diagnostic utility of FNAC as a basis to propose and test a reporting system for bone reporting cytopathology.
This retrospective study is based on patients with bone lesions, that were approached by cytology at Skåne University Hospital, Sweden between 2015 and 2023. The diagnostic performance was measured by sensitivity, specificity and accuracy analyses. All diagnoses were then distributed in six categories: (I) Non-diagnostic, (II) Benign, (III) Atypia, (IV) Bone neoplasm of uncertain significance, (V) Suspicious for malignancy and (VI) Malignant. The risk of malignancy (ROM) in each category was calculated.
The final cohort consisted of 721 cases. Bone cytology was able to differentiate between benign and malignant lesion with a sensitivity of 89% and a specificity of 99%. The overall diagnostic accuracy was 65% but varied significantly among different types of lesions. Within the tested diagnostic categories, the ROM was (I) 48%, (II) 6.7%, (III) 69%, (IV) 28%, (V) 93% and (VI) 100%.
FNAC from bone lesions is a sensitive and specific diagnostic tool with high diagnostic accuracy among various tumour types. This study provides valuable insights for the development of a standardised reporting system for bone cytopathology.
骨病变细针穿刺抽吸细胞学检查（FNAC）已被证明是一种有用的诊断工具，但缺乏标准化。本研究的目的是评估FNAC的诊断效用，以此为基础提出并测试骨细胞病理学报告系统。
这项回顾性研究基于2015年至2023年期间在瑞典斯科讷大学医院接受细胞学检查的骨病变患者。通过敏感性、特异性和准确性分析来衡量诊断性能。然后将所有诊断分为六类：（I）无法诊断，（II）良性，（III）非典型性，（IV）意义不明确的骨肿瘤，（V）可疑恶性和（VI）恶性。计算每类中的恶性风险（ROM）。
最终队列包括721例病例。骨细胞学能够区分良性和恶性病变，敏感性为89%，特异性为99%。总体诊断准确性为65%，但在不同类型的病变中差异很大。在测试的诊断类别中，ROM分别为（I）48%，（II）6.7%，（III）69%，（IV）28%，（V）93%和（VI）100%。
骨病变的FNAC是一种敏感且特异的诊断工具，在各种肿瘤类型中具有较高的诊断准确性。本研究为骨细胞病理学标准化报告系统的开发提供了有价值的见解。
