Das Sudipta, Das Aseema, Das Bandita
Department of Pathology, Nagaon Medical College Hospital, Nagaon, Assam, India.
Department of Pathology, AIIMS-Guwahati, Assam, India.
J Cytol. 2024 Oct-Dec;41(4):201-206. doi: 10.4103/joc.joc_168_23. Epub 2024 Nov 8.
Fine-needle aspiration cytology (FNAC) of the lymph nodes is the first-line evaluation of lymphadenopathy of unknown etiology. For better diagnostic clarity and proper communication to clinicians, the Sydney System was proposed in 2020 for the performance, classification, and reporting of lymph node cytopathology. The present study was conducted to analyze the diagnostic performance and risk of malignancy (ROM) associated with each of the diagnostic categories of the proposed Sydney System.
This retrospective study was conducted over 2 years. All patients with lymphadenopathy undergoing FNAC during the study period for which subsequent histopathological examination (HPE) reports or clinical follow-up data were available were included in the study. The original diagnoses were reviewed, and each case was assessed according to the first diagnostic level of the Sydney System classification. The diagnostic accuracy and ROM were correlated with FNAC diagnoses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of lymph node FNAC were calculated using SPSS version 20.0.
A total of 456 out of 753 cases were selected in the study as they had subsequent histopathological correlation and/or clinical follow-up data. The majority were females = 294 (64.4%). The most common lymph node was the cervical group ( = 274, 60%).
sensitivity 82.8%, specificity 97.5%, PPV 95.3%, NPV 90.1%, and diagnostic accuracy 92%.
The sydney system, which introduces a uniform categorization, may increase the lymph node FNAC diagnostic accuracy.
淋巴结细针穿刺细胞学检查（FNAC）是对病因不明的淋巴结病进行一线评估的方法。为了获得更好的诊断清晰度并与临床医生进行恰当沟通，2020年提出了悉尼系统用于淋巴结细胞病理学的操作、分类和报告。本研究旨在分析所提出的悉尼系统各诊断类别的诊断性能和恶性风险（ROM）。
本回顾性研究历时2年。研究纳入了在研究期间接受FNAC检查且有后续组织病理学检查（HPE）报告或临床随访数据的所有淋巴结病患者。对原始诊断进行回顾，并根据悉尼系统分类的第一诊断水平对每个病例进行评估。将诊断准确性和ROM与FNAC诊断相关联。使用SPSS 20.0版计算淋巴结FNAC的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性。
在753例病例中，共有456例被选入研究，因为它们有后续的组织病理学相关性和/或临床随访数据。大多数为女性 = 294例（64.4%）。最常见的淋巴结部位是颈部组（ = 274例，60%）。
敏感性82.8%，特异性97.5%，PPV 95.3%，NPV 90.1%，诊断准确性92%。
引入统一分类的悉尼系统可能会提高淋巴结FNAC的诊断准确性。
