Santos Caio Rodrigo Dos, Silva Daniel José Castilho da, Camilo-Júnior Deolino João, Xavier-Júnior José Candido Caldeira
School of Medicine, Centro Universitário Unisalesiano Auxilium, Araçatuba, Brazil.
Pathology Institute of Araçatuba, Araçatuba, Brazil.
Acta Cytol. 2025;69(2):154-160. doi: 10.1159/000543045. Epub 2024 Dec 9.
The International Academy of Cytology and the American Society of Cytopathology developed the International System of Serous Fluid Cytopathology (TIS) to standardize cytological reports. Effusions in pleural, peritoneal, and pericardial cavities are valuable sources of information for medical diagnosis, especially in oncological scenarios. The TIS classification is divided into five categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspected malignancy (SFM), and malignant (MAL). It facilitates global communication between specialists, aiming for future clinical management guidelines based on malignancy risk assessment.
This quantitative analytical and retrospective study evaluated serous fluids (pleural, pericardial, and peritoneal) sent to the Instituto de Patologia de Araçatuba (IPAT), São Paulo, Brazil, from public and private hospitals between January 2017 and December 2022. Epidemiological and clinical data were collected from institutional files, including biopsies and immunohistochemical results.
The study included 719 patients with 763 serous fluid samples (pericardial, pleural, and peritoneal) analyzed over 6 years. The majority of samples were from pleural effusions (n = 438; 57.4%), followed by peritoneal (n = 293; 38.4%) and pericardial effusions (n = 32; 4.2%). Samples were classified using the International Serous Fluid Cytopathology System (TIS), revealing the following distribution: ND (0.41%), NFM (70.30%), AUS (0.95%), SFM (11.90%), and MAL (16.44%). The risk of malignancy calculated for each category was ND 66.67%, NFM 23.39%, AUS 28.57%, SFM 48.28%, and MAL 84.17%.
The ROM was out of the interval proposed by the TIS in all categories. These findings suggest the applicability of TIS even outside of the cancer center environment, although the presented ROM frequencies were out of the recommended range.
国际细胞学会和美国细胞病理学学会制定了国际浆液性液体细胞病理学系统（TIS），以规范细胞学报告。胸膜腔、腹膜腔和心包腔积液是医学诊断的重要信息来源，尤其是在肿瘤学场景中。TIS分类分为五类：无法诊断（ND）、恶性阴性（NFM）、意义不明确的非典型性（AUS）、疑似恶性（SFM）和恶性（MAL）。它促进了专家之间的全球交流，旨在制定基于恶性风险评估的未来临床管理指南。
这项定量分析和回顾性研究评估了2017年1月至2022年12月期间从巴西圣保罗阿拉萨图巴病理研究所（IPAT）的公立医院和私立医院送检的浆液性液体（胸膜、心包和腹膜）。从机构档案中收集流行病学和临床数据，包括活检和免疫组化结果。
该研究纳入了719例患者，在6年期间共分析了763份浆液性液体样本（心包、胸膜和腹膜）。大多数样本来自胸腔积液（n = 438；57.4%），其次是腹腔积液（n = 293；38.4%）和心包积液（n = 32；4.2%）。使用国际浆液性液体细胞病理学系统（TIS）对样本进行分类，结果显示以下分布：ND（0.41%）、NFM（7
