INTRODUCTION The classification of lung carcinoma is based on small biopsies and/or cytology in 80% of patients with non-small cell carcinoma. However, there is no widely accepted classification system for respiratory cytology. The Japan Lung Cancer Society (JLCS) and Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma with the following categories: (1) "negative for malignancy," (2) "atypical cells," (3) "suspicious for malignancy," and (4) "malignancy." OBJECTIVE The aim of this work was to perform an interobserver reproducibility study to confirm the utility of the four-tiered reporting system on respiratory cytological samples. METHODS We analyzed 90 cytological samples obtained with bronchoscopy. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the three-, four-, and five-tiered reporting systems. RESULTS The interobserver agreement was fair in the three- (κ = 0.50), four- (κ = 0.45), and five-tiered (κ = 0.45) reporting systems. However, the four-tiered reporting system provided more precise information than the three-tiered reporting system in patient management. The risk of malignancy in the four-tiered reporting system was also stratified well: 19.3% for "negative for malignancy," 45.6% for "atypical cells," 74.7% for "suspicious for malignancy," and 88.1% for "malignancy." CONCLUSIONS The reporting system proposed by the JLCS and JSCC was designed to enhance the communication between clinicians and pathologists and among different institutions. It is simple and applicable to cytological diagnosis of any respiratory diseases. We propose establishing an international classification for respiratory cytology, harmonizing the reporting systems proposed by different countries.

中文翻译：

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日本肺癌学会和日本临床细胞学会的肺癌细胞学报告系统：观察者间可重复性研究和细胞学标本恶性肿瘤风险评估。

引言 肺癌的分类基于 80% 的非小细胞癌患者的小活检和/或细胞学检查。然而，呼吸细胞学还没有被广泛接受的分类系统。日本肺癌学会（JLCS）和日本临床细胞学学会（JSCC）提出了一种新的四级肺癌细胞学报告系统，分类如下：（1）“恶性肿瘤阴性”，（2）“非典型细胞” 、”（3）“疑似恶性肿瘤”和（4）“恶性肿瘤”。目标 这项工作的目的是进行观察者间可重复性研究，以确认四层报告系统对呼吸道细胞学样本的效用。方法 我们分析了支气管镜检查获得的 90 个细胞学样本。七名观察员根据三级、四级和五级报告系统，通过审查每个病例的一张巴氏染色玻片将这些病例分为每一类。结果 在三级 (κ = 0.50)、四级 (κ = 0.45) 和五级 (κ = 0.45) 报告系统中，观察者间的一致性是公平的。但是，在患者管理方面，四级报告系统比三层报告系统提供了更精确的信息。四级报告系统中的恶性肿瘤风险也得到了很好的分层：“恶性肿瘤阴性”为 19.3%，“非典型细胞”为 45.6%，“恶性肿瘤”为 74.7%，“恶性肿瘤”为 88.1%。结论 JLCS 和 JSCC 提出的报告系统旨在加强临床医生和病理学家之间以及不同机构之间的沟通。它操作简单，适用于任何呼吸系统疾病的细胞学诊断。我们建议建立呼吸细胞学国际分类，协调不同国家提出的报告系统。