Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System
The Papanicolaou Society of Cytopathology (PSC) reporting system classifies pancreatobiliary samples into six categories (I–VI), providing guidance for personalized management. As the World Health Organization (WHO) has been preparing an updated reporting system for pancreatobiliary cytopathology, t...
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| Format: | Article |
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MDPI AG
2022-01-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/23/3/1650 |
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| author | Ilias P. Nikas Tanja Proctor Svenja Seide Stylianos S. Chatziioannou Jordan P. Reynolds Dimitrios Ntourakis |
| author_facet | Ilias P. Nikas Tanja Proctor Svenja Seide Stylianos S. Chatziioannou Jordan P. Reynolds Dimitrios Ntourakis |
| author_sort | Ilias P. Nikas |
| collection | DOAJ |
| description | The Papanicolaou Society of Cytopathology (PSC) reporting system classifies pancreatobiliary samples into six categories (I–VI), providing guidance for personalized management. As the World Health Organization (WHO) has been preparing an updated reporting system for pancreatobiliary cytopathology, this systematic review aimed to evaluate the risk of malignancy (ROM) of each PSC category, also the sensitivity and specificity of pancreatic FNA cytology using the current PSC system. Five databases were investigated with a predefined search algorithm. Inclusion and exclusion criteria were applied to select the eligible studies for subsequent data extraction. A study quality assessment was also performed. Eight studies were included in the qualitative analysis. The ROM of the PSC categories I, II, III, IV, V, VI were in the ranges of 8–50%, 0–40%, 28–100%, 0–31%, 82–100%, and 97–100%, respectively. Notably, the ROM IVB (“neoplastic—benign”) subcategory showed a 0% ROM. Four of the included studies reported separately the ROMs for the IVO subcategory (“neoplastic—other”; its overall ROM ranged from 0 to 34%) with low (LGA) and high-grade atypia (HGA). ROM for LGA ranged from 4.3 to 19%, whereas ROM for HGA from 64 to 95.2%. When the subcategory IVO with HGA was considered as cytologically positive, together with the categories V and VI, there was a higher sensitivity of pancreatic cytology, at minimal expense of the specificity. Evidence suggests the proposed WHO international system changes—shifting the IVB entities into the “benign/negative for malignancy” category and establishing two new categories, the “pancreatic neoplasm, low-risk/grade” and “pancreatic neoplasm, high-risk/grade”—could stratify pancreatic neoplasms more effectively than the current PSC system. |
| first_indexed | 2024-03-09T23:46:11Z |
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| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T23:46:11Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-d8045623c7b54e4b96f407e615ee61442023-11-23T16:44:03ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-01-01233165010.3390/ijms23031650Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International SystemIlias P. Nikas0Tanja Proctor1Svenja Seide2Stylianos S. Chatziioannou3Jordan P. Reynolds4Dimitrios Ntourakis5School of Medicine, European University Cyprus, Nicosia 2404, CyprusInstitute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, GermanyInstitute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, GermanySchool of Medicine, European University Cyprus, Nicosia 2404, CyprusDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL 32256, USASchool of Medicine, European University Cyprus, Nicosia 2404, CyprusThe Papanicolaou Society of Cytopathology (PSC) reporting system classifies pancreatobiliary samples into six categories (I–VI), providing guidance for personalized management. As the World Health Organization (WHO) has been preparing an updated reporting system for pancreatobiliary cytopathology, this systematic review aimed to evaluate the risk of malignancy (ROM) of each PSC category, also the sensitivity and specificity of pancreatic FNA cytology using the current PSC system. Five databases were investigated with a predefined search algorithm. Inclusion and exclusion criteria were applied to select the eligible studies for subsequent data extraction. A study quality assessment was also performed. Eight studies were included in the qualitative analysis. The ROM of the PSC categories I, II, III, IV, V, VI were in the ranges of 8–50%, 0–40%, 28–100%, 0–31%, 82–100%, and 97–100%, respectively. Notably, the ROM IVB (“neoplastic—benign”) subcategory showed a 0% ROM. Four of the included studies reported separately the ROMs for the IVO subcategory (“neoplastic—other”; its overall ROM ranged from 0 to 34%) with low (LGA) and high-grade atypia (HGA). ROM for LGA ranged from 4.3 to 19%, whereas ROM for HGA from 64 to 95.2%. When the subcategory IVO with HGA was considered as cytologically positive, together with the categories V and VI, there was a higher sensitivity of pancreatic cytology, at minimal expense of the specificity. Evidence suggests the proposed WHO international system changes—shifting the IVB entities into the “benign/negative for malignancy” category and establishing two new categories, the “pancreatic neoplasm, low-risk/grade” and “pancreatic neoplasm, high-risk/grade”—could stratify pancreatic neoplasms more effectively than the current PSC system.https://www.mdpi.com/1422-0067/23/3/1650pancreasendoscopic ultrasound-guided fine needle aspiration (EUS-FNA)immunohistochemistrypathologymolecularcancer |
| spellingShingle | Ilias P. Nikas Tanja Proctor Svenja Seide Stylianos S. Chatziioannou Jordan P. Reynolds Dimitrios Ntourakis Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System International Journal of Molecular Sciences pancreas endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) immunohistochemistry pathology molecular cancer |
| title | Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System |
| title_full | Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System |
| title_fullStr | Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System |
| title_full_unstemmed | Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System |
| title_short | Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System |
| title_sort | diagnostic performance of pancreatic cytology with the papanicolaou society of cytopathology system a systematic review before shifting into the upcoming who international system |
| topic | pancreas endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) immunohistochemistry pathology molecular cancer |
| url | https://www.mdpi.com/1422-0067/23/3/1650 |
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