Τίτλος:
Fine needle aspiration cytology of nodular thyroid lesions: a 2-year
experience of the Bethesda system for reporting thyroid cytopathology in
a large regional and a university hospital, with histological
correlation
Περίληψη:
ObjectiveThyroid fine needle aspiration (FNA) contributes to the
appropriate management of nodular thyroid lesions. The introduced
categories in the Bethesda system for reporting thyroid cytopathology
(TBSRTC) are associated with an implied cancer risk, providing a
clinical management guideline. This study aims to evaluate the
reproducibility of this implied risk and to compare the results from two
different cytopathology departments.
MethodsFive hundred histologically confirmed FNAs, studied since the
introduction of TBSRTC, were obtained from 4208 and 3587 FNAs performed
in a large regional hospital in Herakleion, Crete (group A) and a
university hospital in Athens (group B), respectively. Reports were
issued according to TBSRTC. Aspirates were prepared with ThinPrep((R))
and evaluated by two experienced cytopathologists. The reproducibility
and accuracy were evaluated.
ResultsThe proportion test for suspicious for malignancy (SFM) and
malignant (M) cytology reports (P<0.0001), and the number of
malignancies on histology (P<0.0001), were significantly higher in group
A than in group B, consistent with a higher incidence of thyroid
carcinomas in southern Greece. Although the malignancy rates were higher
in group A than in group B for all categories, except M (A, 99.3%; B,
100%), the difference was only significant for benign aspirates
(P=0.0303). Malignancy rates for all categories in group A were above
the TBSRTC recommended range, but were consistent with an increased
prevalence of malignancy in that centre, differences in reporting
practice and the variable ranges reported in the literature. There was
lower sensitivity (P=0.019) and overall accuracy (P=0.003) in group A
relative to group B, but no difference in specificity.
ConclusionsTBSRTC provides valuable information for the appropriate
management of nodular thyroid lesions, both in a university and a large
regional hospital.
Συγγραφείς:
Mastorakis, E.
Meristoudis, C.
Margari, N.
Pouliakis, A. and
Leventakos, K.
Chroniaris, N.
Panayiotides, I.
Karakitsos,
P.
