Real-world experience with the Sydney System on 1458 cases of lymph node fine needle aspiration cytology
| Autor: | Alessandro Caputo, Rosalba Fumo, Valentina Giudice, Angela D'Ardia, Pio Zeppa, Antonio D'Antonio, Valeria Ciliberti, Francesco Sabbatino, L Pezzullo |
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| Přispěvatelé: | Caputo, A., Ciliberti, V., D'Antonio, A., D'Ardia, A., Fumo, R., Giudice, V., Pezzullo, L., Sabbatino, F., Zeppa, P. |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Histology Cytodiagnosis Risk of malignancy Biopsy Fine-Needle Cytological Techniques lymphoma Sydney System Pathology and Forensic Medicine cytopathology fine needle aspiration lymph node medicine Humans Medical diagnosis skin and connective tissue diseases Lymph node Retrospective Studies Predictive biomarker medicine.diagnostic_test business.industry Benignity Retrospective cohort study General Medicine body regions Fine-needle aspiration medicine.anatomical_structure Cytopathology Lymph Nodes Radiology business |
| Popis: | Introduction: Lymph node (LN) fine needle aspiration cytology (FNAC) is a safe, quick, inexpensive, reliable, and minimally invasive technique for the diagnosis of lymphadenopathies. Recently, an international committee of experts proposed guidelines for the performance, classification, and reporting of LN-FNAC: the Sydney System. We set out to analyse the diagnostic performance of the Sydney System in a retrospective study. Methods: We retrieved 1458 LN-FNACs, reformulated the diagnoses according to the Sydney System, and compared them to the histological control where available (n = 551, 37.8%). Results: The risk of malignancy for each of the five categories was 66.7% for inadequate/insufficient, 9.38% for benign (overall: 0.84%), 28.6% for atypical, 100% for suspicious and 99.8% for malignant. LN-FNAC showed a sensitivity of 97.94%, a specificity of 96.92%, a positive predictive value of 99.58%, and a negative predictive value of 86.30%. Conclusions: These data support the usage of LN-FNAC as an agile first-level technique in the diagnosis of lymphadenopathies. The Sydney System supports and enhances this role of LN-FNAC, and its adoption is encouraged. In negative cases, coupled with ancillary techniques, LN-FNAC can reassure the clinician regarding the benignity of a lymphadenopathy and indicate the need for clinical follow-up, which will catch possible false negatives. In positive cases, LN-FNAC can provide sufficient information, including predictive biomarkers, to initiate management and obviate the need for subsequent, more invasive procedures. Given its speed, minimal invasiveness, and low cost, LN-FNAC can be performed in most cases, even when more invasive techniques are not feasible. |
| Databáze: | OpenAIRE |
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