{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T14:51:37Z","timestamp":1747147897199,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T00:00:00Z","timestamp":1560902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pseudomyxoma peritonei (PMP) is a rare condition characterized by intraperitoneal accumulation of mucus due to mucinous neoplasia. The characteristic cytological feature of PMP in the ascites is abundant mucus with or without epithelial cell clusters. However, the prognostic significance of the presence of epithelial cell clusters has not been determined. This study aimed to determine the prognostic significance of epithelial cell clusters in the ascites of patients with PMP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who were clinically and histopathologically diagnosed with PMP and who underwent intraoperative cytological examination of their ascites were included in this study. Cytological characteristics including mucus and epithelial cell clusters, nuclear atypia, and the presence of signet ring cells were investigated. Overall survival was compared based on the presence of epithelial cell clusters or nuclear atypia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 283 patients (199 women and 84 men) were investigated. The most common original site was the appendix (244 patients). Ninety patients (31.8%) had mucus without epithelial cell clusters (acellular mucin) while 193 (68.2%) had mucus with such clusters; 134 (69.4%) and 44 (22.8%) of these patients showed low\u2010grade and high\u2010grade nuclear features, respectively. Signet ring cells were detected in 15 patients (7.8%). The presence of epithelial cell clusters did not influence overall survival (<jats:italic>P\u2009=<\/jats:italic> .28); however, high\u2010grade nuclear features and signet ring cell presence were significant negative prognostic factors (<jats:italic>P\u2009&lt;<\/jats:italic> .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of high\u2010grade nuclear features or of signet ring cells should be carefully investigated in the cytological specimens of patients with PMP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24262","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T05:13:38Z","timestamp":1561007618000},"page":"1024-1027","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic significance of the presence of epithelial cell clusters in the ascites of patients with pseudomyxoma peritonei"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0607-8920","authenticated-orcid":false,"given":"Mitsuaki","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Kansai Medical University  Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiyoshi","family":"Mizumoto","sequence":"additional","affiliation":[{"name":"Department of Surgery and Peritoneal Dissemination Center Kusatsu General Hospital  Kusatsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Yonemura","sequence":"additional","affiliation":[{"name":"Department of Surgery and Peritoneal Dissemination Center Kusatsu General Hospital  Kusatsu Shiga Japan"},{"name":"NPO to Support Peritoneal Surface Malignancy Treatment  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ippei","family":"Kashu","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Kusatsu General Hospital  Kusatsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shizuki","family":"Takemura","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Kusatsu General Hospital  Kusatsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Tsuta","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Kansai Medical University  Hirakata Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000535"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2012-200843"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12331"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880370"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000225)90:1<17::AID-CNCR3>3.0.CO;2-D"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199702)16:2<182::AID-DC19>3.0.CO;2-I"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199602)14:1<10::AID-DC3>3.0.CO;2-Z"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199608)15:2<144::AID-DC13>3.0.CO;2-H"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840090616"},{"key":"e_1_2_6_11_1","first-page":"299","article-title":"Pseudomyxoma peritonei associated with ovarian mucinous tumors. 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