INTRODUCTION Fine-needle aspiration cytology (FNAC) is an established first-line technique for the evaluation of lymphadenopathy and, with the help of ancillary testing, can in many instances obviate the need for an open biopsy. The Sydney system was recently proposed to provide consensus guidelines for the performance, classification, and reporting of lymph node FNAC. The present study was undertaken to evaluate its utility and study the impact of rapid on-site evaluation (ROSE). MATERIAL AND METHODS A retrospective analysis in which 1,500 lymph node FNACs was reviewed and assigned a diagnostic category from the Sydney system. Cyto-histopathological correlation and adequacy parameters were evaluated. OBSERVATION AND RESULTS The cervical group of lymph nodes was the commonest group aspirated (89.7%). A total of 1,205/1,500 (80.3%) cases were category II (benign), and necrotizing granulomatous lymphadenitis was the most common pathology. The 750 cases with ROSE were subclassified as follows: 15 category I (inadequate), 629 category II (benign), 2 category III (atypia of undetermined significance), 9 category IV (suspicious for malignancy), and 95 category V (malignant). Among 750 cases without ROSE, 75 cases were in category I, 576 in category II, 3 in category III, 6 in category IV, and 90 in category V. Category I was thus significantly lower in the ROSE group compared to the non-ROSE group. Overall, the risk of malignancy was L1-0%, L2-0.20%, L3-100%, L4-92.3%, and L5-100%. Accuracy parameters revealed a sensitivity of 97.7%, specificity of 100%, PPV of 100%, NPV of 99.10%, and diagnostic accuracy of 99.54%. DISCUSSION AND CONCLUSION FNAC can be used as the 1st line of treatment for lymph node pathology. ROSE can be used as an add-on to FNAC for reducing unsatisfactory rates and help triage material for ancillary testing whenever possible. The Sydney system should be implemented for achieving uniformity and reproducibility.

中文翻译：

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拟议的悉尼系统用于淋巴结细针抽吸细胞病理学分类的效用：三级护理中心的回顾性研究。

简介 细针抽吸细胞学 (FNAC) 是一种成熟的评估淋巴结肿大的一线技术，在辅助测试的帮助下，在许多情况下可以避免进行开放活检。悉尼系统最近被提议为淋巴结 FNAC 的表现、分类和报告提供共识指南。本研究旨在评估其实用性并研究快速现场评估（ROSE）的影响。材料和方法 一项回顾性分析，其中审查了 1,500 个淋巴结 FNAC，并根据悉尼系统分配了诊断类别。评估细胞组织病理学相关性和充分性参数。观察与结果 颈部淋巴结组是最常被抽吸的组（89.7%）。共有 1,205/1,500 例（80.3%）病例为 II 类（良性），坏死性肉芽肿性淋巴结炎是最常见的病理。750例ROSE病例细分如下：I类（不充分）15例，II类（良性）629例，III类（意义不明的异型性）2例，IV类（可疑恶性）9例，V类（恶性）95例。在750例没有ROSE的病例中，75例属于I类，576例属于II类，3例属于III类，6例属于IV类，90例属于V类。因此，与非ROSE组相比，ROSE组的I类明显较低团体。总体而言，恶性肿瘤的风险为L1-0%、L2-0.20%、L3-100%、L4-92.3%和L5-100%。准确性参数显示敏感性为 97.7%，特异性为 100%，PPV 为 100%，NPV 为 99.10%，诊断准确性为 99.54%。讨论与结论 FNAC 可作为淋巴结病理的第一线治疗方法。ROSE 可用作 FNAC 的附加组件，以降低不满意率，并尽可能帮助分类材料以进行辅助测试。悉尼系统的实施应实现一致性和可重复性。