{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:27:35Z","timestamp":1792013255529,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The International System for Reporting Serous Fluid Cytopathology (ISRSFC) was published recently to provide standard reporting terminology for serous fluid. To date, several ISRSFC reclassification studies have reported a wide range of diagnostic category frequency and the associated risk of malignancy (ROM). Herein, the authors applied the ISRSFC to report pleural and peritoneal effusions retrospectively in a community hospital setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>With Internal Review Board approval, 446 peritoneal effusion specimens and 299 pleural fluid specimens from 576 patients in three community hospitals over a 12\u2010month period were reviewed and reclassified according to the ISRSFC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After reclassification, in pleural effusions, 18 (5.0%) were nondiagnostic (ND), 273 (76.0%) were negative for malignancy (NFM), 18 (5.0%) were atypia of undetermined significance (AUS), 6 (1.7%) were suspicious for malignancy (SFM), and 44 (12.3%) were malignant (MAL). In peritoneal effusions, after reclassification, 11 (5.5%) were ND, 168 (77.1%) were NFM, 9 (4.1%) were AUS, 2 (0.9%) were SFM, and 27 (12.4%) were MAL. The calculated ROM was 0.0% for ND, 1.8% for NFM, 37.5% for AUS, 83.3% for SFM, and 100.0% for MAL in peritoneal effusions; and the ROM was 8.3% for ND, 1.2% for NFM, 44.4% for AUS, and 100.0% for both SFM and MAL in pleural effusions. Further analysis demonstrated notable heterogeneity among published ISRSFC reclassification studies, although the overall ROMs did not differ significantly from the ISRSFC\u2010determined ROMs (all <jats:italic>p<\/jats:italic> values were\u2009&gt;\u2009.05 for mean ROM comparisons).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings suggested the necessity for each laboratory to perform its own ROM analysis based on its statistics for ISRSFC\u2010tiered classification terminology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22638","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T12:00:02Z","timestamp":1661169602000},"page":"964-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Risk of malignancy assessment of the <scp>I<\/scp>nternational <scp>S<\/scp>ystem for <scp>R<\/scp>eporting <scp>S<\/scp>erous <scp>F<\/scp>luid <scp>C<\/scp>ytopathology: Experience in a community hospital setting and comparison with other studies"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7731-9309","authenticated-orcid":false,"given":"Tong","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24663"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12654"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22322"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2019.08.006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2020.05.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000501536"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22369"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24440"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000524144"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11061126"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24804"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13113"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0243"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21477"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24837"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13089"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11122223"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22345"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24278"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2217\/bmm-2021-0370"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000496568"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22021"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21452"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.2010.00786.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0641"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22312"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24900"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.25259\/CMAS_02_03_2021"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24864"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2011685"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12996"}],"container-title":["Cancer 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