Saharti Samah
Department of Pathology, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Cytojournal. 2025 May 9;22:50. doi: 10.25259/Cytojournal_218_2024. eCollection 2025.
Pancreatic cancer is a major global health challenge with high mortality rates and limited therapeutic options. Fine-needle aspiration (FNA) cytology is a key diagnostic tool, but discrepancies between cytological and histological diagnoses can impact patient management. This study aims to evaluate the diagnostic accuracy of pancreatic FNA using the World Health Organization (WHO) reporting system to assess the risk of malignancy (ROM) across different diagnostic categories.
The WHO reporting system was employed to reclassify 122 FNAs, with 37 cases undergoing subsequent histological correlation to evaluate the ROM. The sensitivity, specificity, positive and negative predictive values, and accuracy of ROM using the WHO system were determined through statistical analyses.
The discrepancy rate between cytology and histology diagnoses was 16.2%. Category 6 (malignant) showed consistent ROM values (89%), confirming its reliability in predicting malignancy. However, Categories 1, 2, and 3 had higher ROM values than previously reported, while Category 4 had a lower ROM. Factors such as small lesion size, poor cellularity, and sampling limitations contributed to diagnostic discrepancies.
The study offers significant insights into the cyto-histopathological correlation in pancreatic FNA, highlighting the effectiveness of the WHO reporting system in ROM assessment. Future research with larger samples is necessary to enhance the accuracy of pancreatic FNA cytology for improved patient outcomes.
胰腺癌是一项重大的全球健康挑战，死亡率高且治疗选择有限。细针穿刺（FNA）细胞学检查是一种关键的诊断工具，但细胞学诊断与组织学诊断之间的差异可能会影响患者的治疗管理。本研究旨在使用世界卫生组织（WHO）报告系统评估胰腺FNA的诊断准确性，以评估不同诊断类别的恶性风险（ROM）。
采用WHO报告系统对122例FNA进行重新分类，其中37例随后进行组织学相关性分析以评估ROM。通过统计分析确定使用WHO系统的ROM的敏感性、特异性、阳性和阴性预测值以及准确性。
细胞学诊断与组织学诊断之间的差异率为16.2%。第6类（恶性）显示出一致的ROM值（89%），证实了其在预测恶性肿瘤方面的可靠性。然而，第1、2和3类的ROM值高于先前报告的值，而第4类的ROM值较低。病变小、细胞数量少和取样限制等因素导致了诊断差异。
该研究为胰腺FNA的细胞-组织病理学相关性提供了重要见解，突出了WHO报告系统在ROM评估中的有效性。未来需要进行更大样本量的研究，以提高胰腺FNA细胞学检查的准确性，从而改善患者预后。
