Categorization of Serous Effusions using the International System for Reporting Serous Fluid Cytopathology and assessment of Risk of Malignancy with Diagnostic Accuracy

Cytopathology ◽  
2021 ◽  
Author(s):  
Sana Ahuja ◽  
Avneesh Malviya
Keyword(s):  
Diagnostic Accuracy ◽  
International System ◽  
Serous Fluid ◽  
Risk Of Malignancy

scholarly journals A Retrospective Analysis of Serous Effusions Based on the Newly Proposed International System for Reporting Serous Fluid Cytopathology: A Report of 3633 Cases in an Oncological Center

2022 ◽  
Author(s):  
Yan-li Zhu ◽  
Wen-hao Ren ◽  
Qian Wang ◽  
Hai-zhu Jin ◽  
Yi-yi Guo ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
International System ◽  
High Specificity ◽  
Serous Effusion ◽  
Serous Fluid ◽  
Preparation Methods ◽  
Cytologic Examination ◽  
Risk Of Malignancy ◽  
The Difference

Abstract Background: The International System for Reporting Serous Fluid Cytopathology (TIS) was recently proposed. We retrospectively applied TIS recommendations for reporting the cytological diagnosis of serous effusions and reported our experience.Methods: All the serous effusions from January 2018 to September 2021 were retrieved from the database. Recategorization was performed using the TIS classification, the risk of malignancy (ROM) was calculated for each TIS category, and the performance evaluation was carried out among different samples (pleural, peritoneal and pericardial effusions) and preparation methods (conventional smears, liquid-based preparations and cell-blocks). Results: A total of 3633 cases were studied, 17 (0.5%) were diagnosed as ND, 1100 (30.3%) as NFM, 101 (2.8%) as AUS, 677 (18.6%) as SFM, and 1738 (47.8%) as MAL. The ROM for the categories were found to be 38.5%, 28.6%, 52.1%, 99.4% and 100%, respectively. The ROM for SFM was significantly higher than that for AUS (P < 0.001), while the difference between the ROMs for the IVa and IVb was insignificant. The sensitivity, negative predictive value(NPV) and diagnostic accuracy of liquid-based preparations were all superior to conventional smears and cell-blocks in detecting abnormalities. Using three preparation methods simultaneously had the highest sensitivity, NPV and diagnostic accuracy.Conclusion: Serous effusion cytology has a high specificity and positive predictive value(PPV), and the TIS is a user-friendly reporting system. Liquid-based preparations could improve the sensitivity of diagnosis, and it is best to use three different preparation methods simultaneously for serous effusion cytologic examination.

scholarly journals Application of the International System for Reporting Serous Fluid Cytopathology with Cytohistological Correlation and Risk of Malignancy Assessment

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2223
Author(s):  
Alexandros Pergaris ◽  
Dimitra Stefanou ◽  
Panagiota Keramari ◽  
Stylianos Sousouris ◽  
Nikolaos Kavantzas ◽  
...  
Keyword(s):  
Clinical Management ◽  
International System ◽  
Diagnostic Category ◽  
Serous Fluid ◽  
Management Guidelines ◽  
Time Period ◽  
Peritoneal Effusion ◽  
Unknown Significance ◽  
Risk Of Malignancy

The International System for Reporting Serous Fluid Cytopathology (TIS) classifies serous effusions into five categories: non-diagnostic (ND), negative for malignancy (NFM), atypia of unknown significance (AUS), suspicious for malignancy (SFM) and malignant (MAL). The main objectives of this classification comprise the establishment of a universal code of communication between cytopathologists and clinicians and histopathologists, as well as between different laboratories worldwide, paving the way for the setting of clinical management guidelines based on the risk of malignancy assessment for each diagnostic category. We retrieved the total number of pleural and peritoneal effusion cases of our department for the three-year time period between 2018 and 2020, yielding a total of 528 and 500 cases, respectively. We then proceeded to reclassify each specimen according to TIS guidelines and calculate the risk of malignancy (ROM) for each category by searching each patients’ histology records, medical history and clinical follow-up. For pleural effusions, 3 (0.57%) cases were classified as ND, 430 (81.44%) cases as NFM, 15 (2.84%) as AUS, 15 (2.84%) as SFM and 65 (12.31%) as MAL. ROM amounted to 0%, 5.3%, 33.33%, 93.33% and 100% for each category, respectively. As far as peritoneal effusions are concerned, 6 (1.2%) were categorized as ND with ROM estimated at 16.66%, 347 (69.4%) as NFM (ROM = 9%), 13 (2.6%) as AUS (ROM = 38.46%), 12 (2.4%) as SFM (ROM = 83.33%) and 122 (24.4%) as MAL (ROM = 100%). Our results underline the utility of the current classification, both as a means of communication between doctors of different specialties and as general guidelines for the further clinical management of patients.

Pleureaergüsse: Zytohistologie als wesentliche Option zum Ausschluss oder zur Bestätigung einer bösartigen Ursache

2021 ◽  
pp. 1-3
Author(s):  
Franz Stanzel
Keyword(s):  
International System ◽  
The Body ◽  
Future Research ◽  
Pleural Effusions ◽  
Serous Fluid ◽  
Pleural Biopsy ◽  
Diagnostic Categories ◽  
Unknown Significance ◽  
Risk Of Malignancy ◽  
Fluid Cytology

The International System for Reporting Serous Fluid Cytology (TIS) was recently developed. Given its novelty, most studies looking into the risk of malignancy (ROM) of serous effusion diagnostic categories were published before the development of TIS. We searched the database of our department for pleural effusions diagnosed in the last five years, excluding those without a corresponding pleural biopsy. Cases were reviewed and reclassified according to the TIS. A cytohistological correlation was performed. In total, 350 pleural effusion specimens with one or more corresponding pleural biopsies were included. After reclassification, 5 (1.43%) were nondiagnostic (ND), 253 (72.29%) were negative for malignancy (NFM), 7 (2.00%) had atypia of unknown significance (AUS), 14 (4.00%) were suspicious for malignancy (SFM), and 71 (20.57%) were malignant (MAL). Calculated ROM was 40% for ND, 20.16% for NFM, 42.86% for AUS, 78.57% for SFM, and 100% for MAL. Effusion cytology sensitivity and specificity were 60.29% and 98.56%, respectively. This is the first publication looking into the cytohistological correlation of a retrospective cohort of pleural effusions based on the TIS. We add to the body of data regarding the ROM for TIS categories, highlighting areas of potential future research.

Reclassification of Serous Fluid Specimens Using the International System for Reporting Serous Fluid Cytopathology (TIS) and Estimating the Risk of Malignancy (ROM)

2021 ◽  
Vol 10 (5) ◽  
pp. S19
Author(s):  
Swikrity Upadhyay Baskota ◽  
Daniel Martinez Coconubo ◽  
Pooja Srivastava ◽  
Mario Saab-Chalhoub ◽  
Samer Khader
Keyword(s):  
International System ◽  
Serous Fluid ◽  
Risk Of Malignancy

scholarly journals Cytohistological Correlation in Pleural Effusions Based on the International System for Reporting Serous Fluid Cytopathology

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1126
Author(s):  
Daniel Pinto ◽  
Eduardo Cruz ◽  
Diamantina Branco ◽  
Cláudia Linares ◽  
Conceição Carvalho ◽  
...  
Keyword(s):  
International System ◽  
The Body ◽  
Future Research ◽  
Pleural Effusions ◽  
Serous Fluid ◽  
Pleural Biopsy ◽  
Diagnostic Categories ◽  
Unknown Significance ◽  
Risk Of Malignancy ◽  
Fluid Cytology

The International System for Reporting Serous Fluid Cytology (TIS) was recently developed. Given its novelty, most studies looking into the risk of malignancy (ROM) of serous effusion diagnostic categories were published before the development of TIS. We searched the database of our department for pleural effusions diagnosed in the last five years, excluding those without a corresponding pleural biopsy. Cases were reviewed and reclassified according to the TIS. A cytohistological correlation was performed. In total, 350 pleural effusion specimens with one or more corresponding pleural biopsies were included. After reclassification, 5 (1.43%) were nondiagnostic (ND), 253 (72.29%) were negative for malignancy (NFM), 7 (2.00%) had atypia of unknown significance (AUS), 14 (4.00%) were suspicious for malignancy (SFM), and 71 (20.57%) were malignant (MAL). Calculated ROM was 40% for ND, 20.16% for NFM, 42.86% for AUS, 78.57% for SFM, and 100% for MAL. Effusion cytology sensitivity and specificity were 60.29% and 98.56%, respectively. This is the first publication looking into the cytohistological correlation of a retrospective cohort of pleural effusions based on the TIS. We add to the body of data regarding the ROM for TIS categories, highlighting areas of potential future research.

scholarly journals Role of human epididymis protein 4 for detection of ovarian carcinoma in adnexal masses: A pilot study

2016 ◽  
Author(s):  
Nidhi Bansal ◽  
A. Suneja ◽  
K. Guleria ◽  
N. B. Vaid ◽  
K. Mishra ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cross Sectional Study ◽  
Ca 125 ◽  
Serum Samples ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Good Discriminator ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Tumours

Introduction: HE4 is a novel tumour biomarker used for early diagnosis of ovarian cancer. This study evaluated the diagnostic accuracy of HE4 alone and in combination with CA125, risk of malignancy index (RMI), risk of malignancy algorithm (ROMA). Methods: It was a cross sectional study conducted recruiting 88 women with adnexal masses who were planned for surgery. After baseline work up and ultrasound examination, serum samples were collected for estimation of CA 125 and HE4 levels. Serum HE4 levels were estimated using ELISA kit. RMI and ROMA score were calculated and diagnostic accuracy of HE4, CA 125, RMI, ROMA and their combination were compared. Cut off for HE4 and ROMA score were calculated using ROC curve. Results: Of 88 subjects, 66 were analyzed with 19 malignant (including 5 LMP) and 47 benign cases. The median value of HE4 among malignant cases was found to be significantly higher than among the benign cases. PPV and NPV of HE4 at a cut off 130.8 pMol/ml was 85.7% and 77.9% respectively. Highest PPV (88.9%) with acceptable NPV (80.7%) was found with ROMA followed by HE4 (PPV 85.7%; NPV 77.97%), RMI (PPV 76.92%; NPV 83%) and CA125 (PPV 52%; NPV 80.85%). Conclusion: HE4 levels were lower in Indian population both in malignant and benign tumours as compared to other studies. HE4 is a good discriminator and gives best accuracy when it is combined with CA125 in a logistic algorithm, ROMA.

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