世界卫生组织 (WHO) 分类系统修订了巴氏细胞病理学会 (PSC) 报告胰胆细胞病理学的系统。为了更好地按细胞学分级对导管内和/或囊性肿瘤进行分层，肿瘤性其他类别被两个新类别取代：胰胆肿瘤，低风险/级别 (PaN-Low) 和胰胆肿瘤，高风险/级别 (PaN-高的）。低度恶性肿瘤被归入恶性类别，良性肿瘤被归入良性/阴性恶性肿瘤类别。机构病理学数据库搜索确定了接受内镜超声引导细针抽吸术 (EUS-FNA) 治疗胰腺病变的患者从 2015 年 1 月到 2022 年 4 月。恶性肿瘤 (ROM) 的绝对风险是通过至少 6 个月的组织学和/或临床随访确定的，并通过比较 WHO 和 PSC 系统计算跨诊断类别的总生存率。总共对 1012 个案例进行了审查和重新分类。 WHO 系统的 ROM 为 8.3%（不充分/不充分/未诊断）、3.2%（良性/阴性）、24.6%（非典型）、9.1%（PaN-Low）、46.7%（PaN-High）、75%（可疑恶性肿瘤） ，并且 100% 为恶性。相比之下，PSC 系统的 ROM 为：非诊断性 7.4%，恶性肿瘤阴性 3.0%，非典型性 23.1%，肿瘤性、良性 0%，肿瘤性、其他 7.3%，可疑恶性肿瘤 75%，以及 100%为恶性。 WHO 系统在总体生存方面表现出优越的分层能力。WHO 系统通过引入 PaN-Low 和 PaN-High 类别并将低度恶性肿瘤重新分配至恶性类别，显着改善了诊断类别中 ROM 和总体生存的分层。使用 WHO 系统分析 EUS-FNA 样本可为指导临床管理提供重要见解。© 2024 美国癌症协会。

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 neoplastic, other category was replaced by two new categories: pancreaticobiliary neoplasm, low-risk/grade (PaN-Low) and pancreaticobiliary neoplasm, high-risk/grade (PaN-High). Low-grade malignancies were placed in the malignant category, and benign neoplasms were placed in the benign/negative for malignancy category.An institutional pathology database search identified patients who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic lesions from January 2015 to April 2022. The absolute risk of malignancy (ROM) was determined by histologic and/or clinical follow-up of at least 6 months, and overall survival rates were calculated across diagnostic categories, comparing the WHO and PSC systems.In total, 1012 cases were reviewed and recategorized. The ROM for the WHO system was 8.3% for insufficient/inadequate/nondiagnostic, 3.2% for benign/negative for malignancy, 24.6% for atypical, 9.1% for PaN-Low, 46.7% for PaN-High, 75% for suspicious for malignancy, and 100% for malignant. Comparatively, the ROM for the PSC system was 7.4% for nondiagnostic, 3.0% for negative for malignancy, 23.1% for atypical, 0% for neoplastic, benign, 7.3% for neoplastic, other, 75% for suspicious for malignancy, and 100% for malignant. The WHO system demonstrated superior stratification for overall survival.The WHO system significantly improves the stratification of ROM and overall survival across diagnostic categories by introducing the PaN-Low and PaN-High categories and reassigning low-grade malignancies to the malignant category. Analyzing EUS-FNA samples with the WHO system provides critical insights for guiding clinical management.© 2024 American Cancer Society.