TY - JOUR
T1 - Diagnostic Criteria of Bile Cytology
T2 - A Multicenter Comparative Study of Conventional and Liquid-Based Cytology in Japan
AU - Naito, Yoshiki
AU - Kawahara, Akihiko
AU - Makino, Ryo
AU - Tokumitsu, Takako
AU - Nagayama, Daisuke
AU - Sadashima, Eiji
AU - Nakamura, Kaori
AU - Nishizaki, Ryoji
AU - Nagatomo, Tadasuke
AU - Fujino, Yukina
AU - Hayakawa, Chie
AU - Mizuguchi, Keishi
AU - Mori, Tatsuya
AU - Hirabayashi, Kenichi
AU - Tajiri, Takuma
N1 - Publisher Copyright:
© 2025 The Author(s). Published by S. Karger AG, Basel.
PY - 2025
Y1 - 2025
N2 - Introduction: The use of liquid-based cytology (LBC) in nongynecological fields has progressively increased. However, studies focusing on the application of LBC in bile cytology are limited, and its efficacy remains uncertain. In this study, we assessed the potential of LBC in bile cytology by evaluating the interobserver agreement. Methods: Bile cytology specimens were collected between 2015 and 2022 by using endoscopic retrograde cholangiopancreatography. Eleven cytotechnologists participated in the evaluation. Digital images of bile cytology specimens prepared using conventional smear (CS), ThinPrep LBC (TP-LBC), and SurePath LBC (SP-LBC) methods (20 cases per preparation method) were assessed for interobserver agreement on 21 diagnostic criteria. The diagnostic accuracy was evaluated using 50 bile cytology cases per preparation method. Results: High interobserver agreement (exact kappa > 0.6) was observed for features, including the loss of nuclear polarity, irregular nuclear spacing, nuclear size variation, and increased nuclear-tocytoplasmic ratio across the CS, TP-LBC, and SP-LBC methods. Malignant cells in TP-LBC appeared smaller and rounder, and formed flat aggregates compared with those in CS. In contrast, the malignant cells in SP-LBC formed threedimensional clusters that overlapped and exhibited higher cellularity than those in CS. The sensitivity of bile cytology was 76.4%, 84.8%, and 93.2% for CS, TP-LBC, and SP-LBC, respectively. Conclusion: The observers consistently recognized malignant cell features in bile cytology, irrespective of the preparation method. Understanding common features and method-specific cellular morphology is crucial for enhancing diagnostic accuracy. Our findings suggest that LBC methods can be effectively applied to bile cytology, potentially offering improved diagnostic accuracy compared with conventional methods.
AB - Introduction: The use of liquid-based cytology (LBC) in nongynecological fields has progressively increased. However, studies focusing on the application of LBC in bile cytology are limited, and its efficacy remains uncertain. In this study, we assessed the potential of LBC in bile cytology by evaluating the interobserver agreement. Methods: Bile cytology specimens were collected between 2015 and 2022 by using endoscopic retrograde cholangiopancreatography. Eleven cytotechnologists participated in the evaluation. Digital images of bile cytology specimens prepared using conventional smear (CS), ThinPrep LBC (TP-LBC), and SurePath LBC (SP-LBC) methods (20 cases per preparation method) were assessed for interobserver agreement on 21 diagnostic criteria. The diagnostic accuracy was evaluated using 50 bile cytology cases per preparation method. Results: High interobserver agreement (exact kappa > 0.6) was observed for features, including the loss of nuclear polarity, irregular nuclear spacing, nuclear size variation, and increased nuclear-tocytoplasmic ratio across the CS, TP-LBC, and SP-LBC methods. Malignant cells in TP-LBC appeared smaller and rounder, and formed flat aggregates compared with those in CS. In contrast, the malignant cells in SP-LBC formed threedimensional clusters that overlapped and exhibited higher cellularity than those in CS. The sensitivity of bile cytology was 76.4%, 84.8%, and 93.2% for CS, TP-LBC, and SP-LBC, respectively. Conclusion: The observers consistently recognized malignant cell features in bile cytology, irrespective of the preparation method. Understanding common features and method-specific cellular morphology is crucial for enhancing diagnostic accuracy. Our findings suggest that LBC methods can be effectively applied to bile cytology, potentially offering improved diagnostic accuracy compared with conventional methods.
KW - Bile cytology
KW - Conventional smear
KW - Diagnostic accuracy
KW - Liquid-based cytology
KW - Multicenter study
UR - http://www.scopus.com/inward/record.url?scp=105002839553&partnerID=8YFLogxK
U2 - 10.1159/000544997
DO - 10.1159/000544997
M3 - 学術論文
C2 - 40024239
AN - SCOPUS:105002839553
SN - 0001-5547
JO - Acta Cytologica
JF - Acta Cytologica
ER -