Sah Khushbu, Kharel Brinda, Prasad Sah Nirmal
Department of Pathology, Madhesh Institute of Health Sciences, Janakpurdham, Madhesh Province, Nepal.
National Medical College Teaching Hospital, Birgunj, Nepal.
Ann Med Surg (Lond). 2025 Apr 22;87(6):3189-3193. doi: 10.1097/MS9.0000000000003322. eCollection 2025 Jun.
The International Academy of Cytology (IAC) has developed a comprehensive and systematic method that defines five categories for reporting breast fine needle aspiration cytology. These categories stratify breast lesions by their risk of malignancy, providing guidance on management for each category. The aim of the study is to analyze the diagnostic utility of the IAC Yokohama system in breast cytology reporting with histopathological correlation.
This was a cross-sectional observational study. The study included 55 patients with clinically suspected breast lumps who underwent Fine Needle Aspiration Cytology for provisional diagnosis, which was later confirmed by corresponding excisional biopsy and histopathology. The collected data following Fine Needle Aspiration Cytology (FNAC) and histopathology were entered into Microsoft Office Excel software 13. Data analysis was performed using SPSS 16. For diagnostic measurement, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. The probability of significance was set at the 5% level.
Among 55 cases of breast lesions on cytopathology as per the International Academy of Cytology Yokohama System, none of the cases were categorized as Insufficient (C1). Twenty-five cases (45.5%) were categorized as C2 (benign), 5 cases (9.1%) were categorized as C3 (atypia, probably benign), 4 cases (7.3%) were categorized as C4 (suspicious for malignancy), and 21 cases (38.3%) were categorized as C5 (malignant). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for cytopathology compared with histopathology were 86.21% (95% CI: 73.76%-98.66%), 100% (95% CI: 100%-100%), 100% (95% CI: 100%-100%), 86.67% (95% CI: 74.29%-99.05%), and 92.7% (95% CI: 85.54%-99.93%), respectively.
The IAC Yokohama system for reporting breast fine needle aspiration cytopathology effectively stratifies patients into five categories and has high sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy with regard to the gold standard histopathology.
国际细胞学会（IAC）已制定了一种全面且系统的方法，该方法为乳腺细针穿刺细胞学报告定义了五个类别。这些类别根据乳腺病变的恶性风险进行分层，为每个类别提供管理指导。本研究的目的是分析IAC横滨系统在乳腺细胞学报告中与组织病理学相关性的诊断效用。
这是一项横断面观察性研究。该研究纳入了55例临床怀疑有乳腺肿块的患者，他们接受了细针穿刺细胞学检查以进行初步诊断，随后通过相应的切除活检和组织病理学检查得以确诊。细针穿刺细胞学检查（FNAC）和组织病理学检查后收集的数据被录入Microsoft Office Excel软件13。使用SPSS 16进行数据分析。为进行诊断测量，计算了敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。显著性概率设定为5%水平。
根据国际细胞学会横滨系统，在55例乳腺病变的细胞病理学检查中，没有病例被归类为不足（C1）。25例（45.5%）被归类为C2（良性），5例（9.1%）被归类为C3（非典型，可能为良性），4例（7.3%）被归类为C4（怀疑恶性），21例（38.3%）被归类为C5（恶性）。与组织病理学相比，细胞病理学的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为86.21%（95%置信区间：73.76%-98.66%）、100%（95%置信区间：100%-100%）、100%（95%置信区间：100%-100%）、86.67%（95%置信区间：74.29%-99.05%）和92.7%（95%置信区间：85.54%-99.93%）。
IAC横滨系统用于乳腺细针穿刺细胞病理学报告能有效地将患者分为五个类别，并且相对于金标准组织病理学具有较高的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。
