A Comprehensive Review of the Newest World Health Organization (WHO) Cytopathology Reporting Systems

Nigam, Jitendra Singh; Bharti, Jyotsna Naresh; Rath, Ashutosh; Pradeep, Immanuel

doi:10.1097/pap.0000000000000404

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…The WHO system is developed as an improvisation of the PSC system to better align with the WHO classification of digestive system tumors and to yield more meaningful ROMs for each category [5, 27]. The use of BDC as a primary method to investigate pancreaticobiliary strictures is common.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Bile Duct Brush Cytology with Risk of Malignancy of Standardized Categories in the Wake of World Health Organization Reporting System for Pancreaticobiliary Cytopathology: An Updated Systematic Review and Meta-Analysis

Rath,

Pradeep,

Nigam

2023

Acta Cytologica

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Introduction: The WHO Reporting System for Pancreaticobiliary Cytopathology revised the Papanicolaou Society of Cytopathology guidelines in alignment with the WHO classification of digestive system tumors, 5th edition. The current systematic review and meta-analysis have been conducted to accurately assess the performance of bile duct brush cytology and report the risk of malignancy (ROM) of each standard category by following the guidelines of diagnostic test accuracy meta-analysis. Methods: Medline/ Pubmed and Cochrane databases were searched till 8th June 2023 with a strategy that included target site (pancreaticobiliary and related terms), diagnostic method (bile duct brushing and related terms), and keywords for diagnostic performance (for Cochrane database). Inclusion criteria included studies that have assessed bile duct cytology (BDC) for pancreaticobiliary duct stricture with a sample size of over 50, provided cytological diagnoses similar to the WHO system with details to deduce true positives, true negatives, false positives, and false negatives through subsequent final diagnoses (Benign vs. Malignant). The exclusion criteria were the fewer sample size, assessment through other cytological categories, limited data, and clinical setting. Two authors independently reviewed the result of the search strategy. The quality of the selected articles was assessed by the QUADAS-2 tool. Bivariate random-effects model was used to get the pooled sensitivity and specificity. Heterogeneity across studies was assessed using I-squared statistics, and potential sources were found using meta-regression. Pooled and a range of ROM in each category was analyzed. Results: Thirteen studies were included with 4398 bile duct brushings. The pooled sensitivity is 0.437 (95% CI: 0.371-0.504), and the pooled specificity is 0.972 (95% CI: 0.943-0.987). The ROM in various categories are as follows: inadequate/non-diagnostic: 23%-100% (pooled- 50.15%), benign/negative for malignancy: 22%-70% (38%), atypical: 0%-95% (66%), suspicious for malignancy: 74%-100% (89%), malignant: 91% to 100% (98%). Conclusion: Even with standard cytological categories, the sensitivity of BDC remains low. The review has analyzed and discussed potential causes of heterogeneity that will be helpful for future diagnostic studies.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Bile Duct Brush Cytology with Risk of Malignancy of Standardized Categories in the Wake of World Health Organization Reporting System for Pancreaticobiliary Cytopathology: An Updated Systematic Review and Meta-Analysis

Rath,

Pradeep,

Nigam

2023

Acta Cytologica

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Evaluating the Risk of Malignancies of the Diagnostic Categories Proposed by the World Health Organization System for Reporting Lung Cytopathology: A 2-Year Single Institutional Experience

Lai,

Chen

2024

Acta Cytologica

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Introduction The WHO System of Reporting Lung Cytopathology proposed a 5-tiered system in 2023. We report the risk of malignancies (ROMs) of bronchial washing/lavage and percutaneous fine needle aspiration (FNA) specimens. We also evaluated the change of ROMs when image correlation is required. Methods Lung cytology cases in 2021 and 2022 with histologic follow-up were included. CT reports were reviewed to identify cases with a solid nodule/tumor but benign cytological findings. These were reassigned from the “Benign” to “Non-diagnostic” category, and the ROMs were re-estimated. Results A total of 1031 bronchial washing/lavage and 206 FNAs were identified. The ROMs of bronchial washing/lavage were “Non-diagnostic” 56.5% (13/23), “Benign” 41.9% (320/764), “Atypical” 71.7% (71/99), “Suspicious for malignancy” 94.7% (72/76), and “Malignant” 100% (70/70). The ROMs of FNAs were “Non-diagnostic” 66% (33/50), “Benign” 58.2% (39/67), “Atypical” 70% (28/40), “Suspicious for malignancy” 96.2% (25/26), and “Malignant” 100% (70/70). When image finding was considered, cases initially assigned as “Benign” were re-classified to “Non-diagnostic” with decreases in ROMs for the “Benign " category. Conclusions Malignancy risks associated with the WHO System of Reporting Lung Cytopathology diagnostic groups were reported. Image correlation for the “Benign” category led to a decrease in case number and ROM.

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A Comprehensive Review of the Newest World Health Organization (WHO) Cytopathology Reporting Systems

Cited by 2 publications

References 6 publications

Diagnostic Performance of Bile Duct Brush Cytology with Risk of Malignancy of Standardized Categories in the Wake of World Health Organization Reporting System for Pancreaticobiliary Cytopathology: An Updated Systematic Review and Meta-Analysis

Diagnostic Performance of Bile Duct Brush Cytology with Risk of Malignancy of Standardized Categories in the Wake of World Health Organization Reporting System for Pancreaticobiliary Cytopathology: An Updated Systematic Review and Meta-Analysis

Evaluating the Risk of Malignancies of the Diagnostic Categories Proposed by the World Health Organization System for Reporting Lung Cytopathology: A 2-Year Single Institutional Experience

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