갑상선 결절에서 세침흡인검사: Bethesda Classification의 임상적 적용
Fine Needle Aspiration for Thyroid Nodule: Clinical Application of Bethesda Classification
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Background and Objectives To evaluate the usefulness of fine needle aspiration (FNA) for thyroid nodule using the new Bethesda classification. Subjects and Method Patient cytology data were reviewed by retrospective search of thyroid FNA. Cytologic diagnoses were classified as unsatisfactory, benign/negative for malignancy,indeterminate (ID), follicular neoplasm (FN), suspicious for malignancy (SM), and positive for malignancy (PM) according to the proposing of The National Cancer Institute. We analyzed the follow-up FNA diagnoses and the cytologic-histologic correlations. Results Of 1983 patients, 16.8% was classified as unsatisfactory, 73.6% as benign, 1.1% as ID,0.4% as FN, 1.4% as SM, and 6.8% as PM. After the cytologic follow-up, the groups designated as unsatisafactory (80.2%) and ID (50%) mainly showed significant change in diagnosis. Two hundred fifty patients had surgical follow-up. Sensitivity, specificity, and accuracy, positive predictive values and negative predictive values for malignancy of thyroid were 87.6%, 97.2%, 91%,98.3% and 81.2%, respectively. The cytologic-histologic diagnostic discrepancy rate was 13.6%. Conclusion FNA for thyroid nodule using the new Bethesda classification was an accurate and sensitive method for the diagnosis of thyroid nodule, and can provide useful information for the management of thyroid nodule. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:436-40
Abstract
Background and Objectives To evaluate the usefulness of fine needle aspiration (FNA) for thyroid nodule using the new Bethesda classification. Subjects and Method Patient cytology data were reviewed by retrospective search of thyroid FNA. Cytologic diagnoses were classified as unsatisfactory, benign/negative for malignancy,indeterminate (ID), follicular neoplasm (FN), suspicious for malignancy (SM), and positive for malignancy (PM) according to the proposing of The National Cancer Institute. We analyzed the follow-up FNA diagnoses and the cytologic-histologic correlations. Results Of 1983 patients, 16.8% was classified as unsatisfactory, 73.6% as benign, 1.1% as ID,0.4% as FN, 1.4% as SM, and 6.8% as PM. After the cytologic follow-up, the groups designated as unsatisafactory (80.2%) and ID (50%) mainly showed significant change in diagnosis. Two hundred fifty patients had surgical follow-up. Sensitivity, specificity, and accuracy, positive predictive values and negative predictive values for malignancy of thyroid were 87.6%, 97.2%, 91%,98.3% and 81.2%, respectively. The cytologic-histologic diagnostic discrepancy rate was 13.6%. Conclusion FNA for thyroid nodule using the new Bethesda classification was an accurate and sensitive method for the diagnosis of thyroid nodule, and can provide useful information for the management of thyroid nodule. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:436-40
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