The International System for Reporting Serous Fluid Cytopathology: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies

• Type: Article in International Scientific Journal
• Date: 2024

Authors

Jamal, FE (Author) Other; Vey, JA (Author) Other; Proctor, T (Author) Other; Ishak, A (Author) Other; Fernando Schmitt (Author) FMUP; Nikas, IP (Author) Other

Journal

Title: Advances in Anatomic Pathology

Vol. 31

Pages: 256-264

ISSN: 1072-4109

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-010-KJ0

DOI: 10.1097/pap.0000000000000454

Abstract (EN): This is the first systematic review and meta-analysis of The International System (TIS) for reporting serous fluid cytopathology. Our aims were to present the pooled malignancy rate of each TIS reporting category and the diagnostic accuracy of cytology using this system. Database search using a predefined strategy was followed by study selection, data extraction, study quality assessment, and statistical analysis. Data derived from 16 eligible studies were pooled. The pooled rates of malignancy were as follows: 27% (95% CI; 16%-41%) for nondiagnostic (ND), 11% (95% CI; 7%-18%) for negative for malignancy (NFM), 49% (95% CI; 37%-61%) for atypia of undetermined significance (AUS), 90% (95% CI; 81%-95%) for suspicious for malignancy (SFM), and 100% (95% CI; 98%-100%) for positive for malignancy (MAL). Studies performed exclusively in cancer hospitals showed higher pooled malignancy rates, compared with academic and community hospitals serving the general population, in the ND [40% (95% CI; 21%-62%) vs. 22% (95% CI; 11%-39%)], NFM [20% (95% CI; 13%-30%) vs. 9% (95% CI; 5%-17%)], and AUS categories [55% (95% CI; 47%-63%) vs. 46% (95% CI; 31%-62%)]. Notably, the difference was significant in the NFM category (P=0.04). When both SFM and MAL cytology interpretations were considered as malignant outcomes, the pooled sensitivity and specificity were 68.74% (95% CI; 59.90%-76.39%) and 98.81% (95% CI; 98.18%-99.22%), respectively. In addition, the diagnostic odds ratio (DOR) was found to be 170.7 (95% CI; 96.2-303.3). Despite its strengths, our study also had some limitations. Therefore, future large-scale longitudinal studies could strengthen the findings of this review.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9