Supplementary Material for: A SYSTEMATIC REVIEW AND META-ANALYSIS ON SEDIMENT CYTOLOGY: AN ADJUNCT TO EARLY DIAGNOSIS

Introduction: Sediment cytology, initially applied in urinary diagnostics, has expanded to formalin-fixed biopsy specimens, evaluating exfoliated cells suspended in formalin fixative. Though traditionally discarded, this sediment contains diagnostic material, especially in friable or malignant tissues. It offers a rapid, cost-effective, preliminary diagnostic tool when histopathology is delayed, such as in bone lesions requiring decalcification. This systematic review aimed to comprehensively assess the diagnostic accuracy, applicability, and limitations of sediment cytology across diverse anatomical sites.
Methods: This systematic review followed PRISMA guidelines, and an electronic search was conducted across PubMed, Scopus, and Google Scholar databases until January 1, 2025, without year restrictions. Keywords included “Sediment cytology”, “oral neoplasms”, “bone lesions”, and related terms. Articles in English reporting sediment cytology on formalin-fixed biopsies with cytological-histological correlation were included.
Results: Nine eligible studies were identified, involving various lesions including OSCC, OPMDs, bone lesions, GIT, cervical and ovarian neoplasms. Pooled sensitivity and specificity were 73.3% and 92.1% respectively. Subgroup analysis revealed excellent concordance for OSCC and bone malignancies. Sensitivity was lower in benign lesions and OPMDs, attributed to poor cellularity and exfoliation. Methodological heterogeneity was noted, though overall bias remained low.
Conclusion: Sediment cytology shows valuable diagnostic potential as a preliminary adjunct to histopathology, particularly for malignancies, warranting further standardized multicenter studies.

引言：沉降细胞学（Sediment cytology）最初应用于尿液诊断领域，如今已拓展至福尔马林固定活检标本检测，用于评估悬浮于福尔马林固定液中的脱落细胞。尽管这类沉降物传统上会被直接丢弃，但其本身蕴含诊断价值极高的生物材料，尤其在易碎组织或恶性组织中。当组织病理学检查因故延迟时（例如需要进行脱钙处理的骨病变），沉降细胞学可作为一种快速、经济的初步诊断手段。本系统综述旨在全面评估沉降细胞学在不同解剖部位的诊断准确性、适用范围及局限性。

方法：本系统综述遵循PRISMA指南，于2025年1月1日前在PubMed、Scopus及Google Scholar数据库中开展电子检索，未设置文献发表年份限制。检索关键词涵盖“沉降细胞学（Sediment cytology）”、“口腔肿瘤”、“骨病变”及相关术语。纳入标准为：以英文发表、针对福尔马林固定活检标本开展沉降细胞学检测且包含细胞学-组织学对照的研究。

结果：最终共纳入9项符合标准的研究，涉及口腔鳞状细胞癌（OSCC）、口腔潜在恶性病变（OPMDs）、骨病变、胃肠道（GIT）、宫颈及卵巢肿瘤等多种病变类型。合并后的灵敏度与特异度分别为73.3%与92.1%。亚组分析显示，口腔鳞状细胞癌与骨恶性肿瘤的检测一致性极佳。良性病变及口腔潜在恶性病变的检测灵敏度较低，这一现象可归因于细胞丰富度不足及脱落效果不佳。研究整体存在方法学异质性，但总体偏倚风险较低。

结论：沉降细胞学作为组织病理学的初步辅助诊断手段，展现出可观的临床应用潜力，尤其在恶性肿瘤相关诊疗场景中，亟需开展标准化的多中心研究以进一步验证其应用价值。