Update on Risk Stratification in the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology Categories: 3‐Year, Prospective, Single‐Institution Experience

In this issue of Cancer Cytopathology (Volume 128, Issue 1, page 29-35), Sung et al. described the significance of using the current standardized reporting terminology,  the Papanicolaou Society of Cytopathology System of Reporting for Pancreaticobiliary Cytology (PSCPC), and the importance of risk stratification strategy for each diagnostic category. This is one of the largest single institution multidisciplinary studies with 3-year prospective data and extensive clinical follow up. Risk of malignancy (ROM) or rate of malignant outcome was highest in the following categories: Category V or Suspicious (95.5%); category VI or Malignant (99.6%); and category IVB or Neoplastic: Other with High-grade Atypia (95.2%). Lower ROMs where identified in the following categories: Category IVB or Neoplastic: Other with Low-grade Atypia (19%) and category III or Atypical (41.8%). This study emphasizes the importance of ROM for each diagnostic category not only for clinical management but also as a tool for internal quality control. Future updates of the PSCPC may need to consider stratifying category IVB: Neoplastic: Other into Low- and High-grade Dysplasia on cytomorphology due to their different rate of malignancy outcomes. Click here to read the full article.