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. 2023 Jun 1;24(6):1917-1922.
doi: 10.31557/APJCP.2023.24.6.1917.

Diagnostic Accuracy of Lymph Nodes Fine Needle Aspiration Biopsy Based on The Sydney System for Reporting Lymph Node Cytology

Juanita Juanita  1   2 , Dzul Ikram  3 , Ni Ketut Sungowati  1   2 , Imeldy Prihatni Purnama  1   2 , Amalia Amalia  1   2 , Andi Ferial Ningrati  1 , Upik Anderiani Miskad  2
Affiliations

Diagnostic Accuracy of Lymph Nodes Fine Needle Aspiration Biopsy Based on The Sydney System for Reporting Lymph Node Cytology

Juanita Juanita et al. Asian Pac J Cancer Prev. .

Abstract

Objective: To evaluate the diagnostic accuracy and malignancy risk of The Sydney System Reporting for Lymph Nodes Cytology.

Material and methods: This study utilized secondary data from 156 cases to conduct a retrospective analysis of a diagnostic test method. During 2019-2021, data were collected at Dr. Wahidin Sudirohusodo's Anatomical Pathology Laboratory in Makassar, Indonesia. The cytology slides of each case were split into five diagnostic groups using the Sydney method, which were then compared with the results of the histopathological diagnosis.

Results: There were six cases in the L1 category, thirty-two cases in the L2 category, thirteen patients in the L3 category, seventeen cases in the L4 category, and ninety-one cases in the L5 class. The malignant probability (MP) is computed for each diagnostic classification. L1 MP value is 66.7%, L2 MP value is 15.6%, L3 MP value is 76.9%, L4 MP value is 94.0%, and L5 MP value is 98.9%. The diagnostic value of the FNAB examination is as follows: 89.9% sensitivity, 92.9% specificity, 98.2% positive predictive value, 68.4% negative predictive value, and 90.47% diagnostic accuracy.

Conclusion: The FNAB examination provides high sensitivity, specificity, and accuracy in diagnosing lymph node tumors. Using a classification based on the Sydney system promotes communication between laboratories and clinicians.<br />.

Keywords: Cytology; FNAB; Malignant Probability; Sydney System Reporting; lymph node.

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Conflict of interest statement

Each author affirms that they have no competing interests.

Figures

Figure 1
Figure 1
A Representative Depiction of Lymph Node Cytology According to the Sydney System Category. A. Only contains necrosis material (L1: Non-diagnostic), Obj.40x; B. Granulomatous lymphadenitis (L2: Benign), Obj.10x; C. Large cells scattered among the lymphocyte cells (L3: AUS), Obj.40x; C. Large cells scattered among the lymphocyte cells (L3: AUS), Obj.40x; D. There are cells resembling datia cells Reed-Sternberg-like cells (L4: Suspicious for malignancy), Obj.40x; Lymph node metastases from adenocarcinoma and Non-Hodgkin lymphoma, respectively (L5: Malignant), obj.40x. (Papanicolauo Stain, Olympus CX-43, Scale bar 10 µm)
Graph 1
Graph 1
Receiver Operating Curve (ROC) of Sensitivity of Cytological Findings Confirmed by Histopathology. The research yielded the subsequent diagnostic measurements: a sensitivity rate of 89.9%, a specificity rate of 92.9%, a positive predictive value of 98.2%, a negative predictive value of 68.4%, and an accuracy rate of 90.47%
See this image and copyright information in PMC

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