title: The impact of the new proposed Papanicolaou Society of Cytopathology terminology for pancreaticobiliary cytology in endoscopic US-FNA: A single-institutional experience.
abstract: BACKGROUND
  The Papanicolaou Society of Cytopathology has recently published a new proposal for pancreaticobiliary cytology terminology. For the current study, the authors applied this new classification for pancreaticobiliary cytology to a set of previously diagnosed endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) samples and correlated the results with those from the corresponding available final surgical specimens.
  
  
  METHODS
  Pancreatic FNA specimens were retrospectively collected from a 12-month period at the Mayo Clinic in Jacksonville, Florida. Cases with cytohistologic disagreement were reviewed to assess the reasons for discrepancies. The sensitivity and specificity of EUS-FNA specimens were assessed using the Pearson chi-square test.
  
  
  RESULTS
  One hundred fifty-five pancreatic FNA specimens were retrieved. The median patient age was 70 years (range, 25-93 years). Eleven specimens previously classified as negative and 3 previously classified as non-diagnostic were reclassified as neoplastic:other, as well as all specimens primarily classified as atypical or positive for neoplasm and half the specimens primarily classified as suspicious. All positive specimens remained within their same categories in the revised classification. Sixteen patients (10.3%) had surgical resection specimens available, and complete or partial agreement with FNA results was achieved in 13 of those surgical specimens (81.2%). Reasons for discrepancy comprised sampling errors in 5 specimens and an interpretation error in 1 specimen. Overall, sensitivity was 66.7%, specificity was 66.7%, the positive predictive value was 88.9%, and the negative predictive value was 33.3%.
  
  
  CONCLUSIONS
  The application of the new proposed terminology for pancreaticobiliary cytology had a greater impact among specimens that were previously classified as atypical and suspicious. EUS-FNA of the pancreas is a highly accurate method, and its use, allied with the new proposed terminology, may ultimately contribute to better outcomes.
authors.affiliation: Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil.|Department of Pathology, Grupo Fleury Laboratories, Sao Paulo, Brazil.
authors.forename: Mauro Ajaj
authors.initials: MA
authors.lastname: Saieg
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Valerie
authors.initials: V
authors.lastname: Munson
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Shanna
authors.initials: S
authors.lastname: Colletti
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Aziza
authors.initials: A
authors.lastname: Nassar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000473:pathology*; D016009:Chi-Square Distribution; D003581:Cytodiagnosis / Q000145:classification*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012955:Societies, Medical / Q000592:standards; D009626:Terminology as Topic
keywords: cytology; endoscopic ultrasound; fine-needle aspiration; pancreas