{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:54:02Z","timestamp":1784930042569,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"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":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The World Health Organization (WHO) classification system revised the Papanicolaou Society of Cytopathology (PSC) system for reporting pancreaticobiliary cytopathology. To better stratify intraductal and\/or cystic neoplasms by cytologic grade, the <jats:italic>neoplastic, other<\/jats:italic> category was replaced by two new categories: <jats:italic>pancreaticobiliary neoplasm, low\u2010risk\/grade<\/jats:italic> <jats:italic>(PaN\u2010Low)<\/jats:italic> and <jats:italic>pancreaticobiliary neoplasm, high\u2010risk\/grade<\/jats:italic> <jats:italic>(PaN\u2010High)<\/jats:italic>. Low\u2010grade malignancies were placed in the <jats:italic>malignant<\/jats:italic> category, and benign neoplasms were placed in the <jats:italic>benign\/negative for malignancy<\/jats:italic> category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An institutional pathology database search identified patients who underwent endoscopic ultrasound\u2010guided fine\u2010needle aspiration (EUS\u2010FNA) for pancreatic lesions from January 2015 to April 2022. The absolute risk of malignancy (ROM) was determined by histologic and\/or clinical follow\u2010up of at least 6 months, and overall survival rates were calculated across diagnostic categories, comparing the WHO and PSC systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1012 cases were reviewed and recategorized. The ROM for the WHO system was 8.3% for <jats:italic>insufficient\/inadequate\/nondiagnostic<\/jats:italic>, 3.2% for <jats:italic>benign\/negative for malignancy<\/jats:italic>, 24.6% for <jats:italic>atypical<\/jats:italic>, 9.1% for <jats:italic>PaN\u2010Low<\/jats:italic>, 46.7% for <jats:italic>PaN\u2010High<\/jats:italic>, 75% for <jats:italic>suspicious for malignancy<\/jats:italic>, and 100% for <jats:italic>malignant<\/jats:italic>. Comparatively, the ROM for the PSC system was 7.4% for <jats:italic>nondiagnostic<\/jats:italic>, 3.0% for <jats:italic>negative for malignancy<\/jats:italic>, 23.1% for <jats:italic>atypical<\/jats:italic>, 0% for <jats:italic>neoplastic, benign<\/jats:italic>, 7.3% for <jats:italic>neoplastic, other<\/jats:italic>, 75% for <jats:italic>suspicious for malignancy<\/jats:italic>, and 100% for <jats:italic>malignant<\/jats:italic>. The WHO system demonstrated superior stratification for overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The WHO system significantly improves the stratification of ROM and overall survival across diagnostic categories by introducing the <jats:italic>PaN\u2010Low<\/jats:italic> and <jats:italic>PaN\u2010High<\/jats:italic> categories and reassigning low\u2010grade malignancies to the <jats:italic>malignant<\/jats:italic> category. Analyzing EUS\u2010FNA samples with the WHO system provides critical insights for guiding clinical management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22880","type":"journal-article","created":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T04:00:35Z","timestamp":1719720035000},"page":"635-645","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk of malignancy and overall survival associated with the diagnostic categories in the World Health Organization Reporting System for Pancreaticobiliary Cytopathology"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2772-6077","authenticated-orcid":false,"given":"Wen\u2010Yu","family":"Hsiao","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-785X","authenticated-orcid":false,"given":"Qun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102303.2007.00457.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2007.08.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432\u2010012\u20101268\u20101"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/2303\u20109027.175879"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/1742\u20106413.133343"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23095"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-16589-9"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.14105"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2019.01.002"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21386"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22199"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21344"},{"key":"e_1_2_7_14_1","volume-title":"IARC","author":"International Academy of Cytology (IAC)\u2010International Agency for Research on Cancer (IARC)\u2010World Health Organization (WHO) Joint Editorial Board","year":"2022"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2023.03.002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527912"},{"key":"e_1_2_7_17_1","volume-title":"Digestive System Tumours. 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