A decade of change: Trends in the practice of cytopathology at a tertiary care cancer centre

Abstract

Objectives The practice of cytopathology has evolved over the past decade with a growing need for doing more with less tissue. Changes in clinical practice guidelines and evolving needs in tissue acquisition for diagnosis and treatment have affected various areas of cytopathology in different ways. In this study, we evaluated the changing trends in cytopathological practice at our institution over the past decade. Methods We performed a retrospective review of our institutional database for cytopathology cases from calendar years 2009 (n = 28038) and 2019 (n = 31386) to evaluate the changing trends in practice. Results The overall number of exfoliative cases decreased 10% over the past decade, primarily due to a 64% decrease in gynaecological Pap testing. However, the volume of serous body cavity and cerebrospinal fluids increased 125% and 44%, respectively. The overall volume of fine needle aspiration (FNA) cases increased 38% from 2009 to 2019. The number of FNA cases increased across most body sites, driven primarily by a 180% increase in endobronchial ultrasound‐guided transbronchial needle aspiration cases. In contrast, breast FNA volume decreased 43%. Ancillary studies increased substantially over the past decade, including immunostains (476%) and molecular testing (250%). Conclusions The trends in our cytopathological practice showed an increased volume of cases, especially in non‐gynaecological specimens. As expected, the number of FNA cases used for immunostains and molecular testing increased substantially, indicating an upward trend in ancillary studies in cytopathological practice.

Geographic Distribution, Number, and Types of Papers Published in International Cytopathology Journals in the Last 5.5 Years: A Preliminary Study

“…In this study, we analyzed the papers published in SCI-indexed international cytology journals by the number and type of paper and geographic distribution according to the country of origin. In parallel with advancements in science and technology, there has been development and change in the field of cytopathology in recent years [5-7]. This has also enhanced interest in cytology journals and led to an increase in their impact factors [8].…”

Optimal Assessment of Metastatic Breast Carcinoma: The Value of Cytopathology Combined with Molecular Analysis

“…Although, in the last decade, we have validated cytology for molecular tests [10] and we have been observing a significant increase in the number of FNA cases and ancillary studies, especially related to lung cancer [39], cytology still needs to be better integrated into routine molecular diagnostics workflow.…”

“…Studies have revealed that cytological specimens produce adequate substrates for molecular analysis and can provide clinically reliable genomic profiling [10,38]. Cytological samples have been reported to be feasible for collecting sufficient tumor samples for DNA and RNA analysis, in single-multiplex genomic assays, including polymerase chain reaction (PCR), Sanger sequencing, and next generation sequencing (NGS) [39].…”

Core needle biopsy for the diagnosis of primary soft tissue lesions: Accuracy and diagnostic challenges

“…Because FNAs generally yield smaller volumes of neoplastic cells than CNBs, concerns have been raised regarding the adequacy of FNA specimens. A number of authors have addressed this issue and concluded that cytologic specimens usually contain sufficient material for reliable molecular and immunohistochemical characterizations 48–53 Studies have generally shown that cell block material is optimal for molecular testing of FNAs but other specimen types may be used including Papanicolaou stained smears. As an increasing number of mutation related sarcomas are described, greater reliance on molecular testing of cytology specimens will undoubtedly occur.…”