Incidence and Malignancy Rates of Diagnoses in the Bethesda System for Reporting Thyroid Aspiration Cytology: An Institutional Experience
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six diagnostic categories to standardize communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists. Since several studies have questioned the diagnostic accuracy of this system, we examined its accuracy in our hospital. Methods: We calculated the incidences and malignancy rates of each diagnostic category in the BSRTC for 1,730 FNAs that were interpreted by four cytopathologists in Gangnam Severance Hospital between October 1, 2011, and December 31, 2011. Results: The diagnostic incidences of categories I-VI were as follows: 13.3%, 40.6%, 9.1%, 0.4%, 19.3%, and 17.3%, respectively. Similarly, the malignancy rates of these categories were as follows: 35.3%, 5.6%, 69.0%, 50.0%, 98.7%, and 98.9%, respectively. In categories II, V, and VI, there were no statistically significant differences in the ranges of the malignancy rates among the four cytopathologists. However, there were significant differences in the ranges for categories I and III. Conclusions: Our findings suggest that institutions that use the BSRTC should regularly update their diagnostic criteria. We also propose that institutions issue an annual report of incidences and malignancy rates to help other clinicians improve the case management of patients with thyroid nodules.
Abstract
Background: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six diagnostic categories to standardize communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists. Since several studies have questioned the diagnostic accuracy of this system, we examined its accuracy in our hospital. Methods: We calculated the incidences and malignancy rates of each diagnostic category in the BSRTC for 1,730 FNAs that were interpreted by four cytopathologists in Gangnam Severance Hospital between October 1, 2011, and December 31, 2011. Results: The diagnostic incidences of categories I-VI were as follows: 13.3%, 40.6%, 9.1%, 0.4%, 19.3%, and 17.3%, respectively. Similarly, the malignancy rates of these categories were as follows: 35.3%, 5.6%, 69.0%, 50.0%, 98.7%, and 98.9%, respectively. In categories II, V, and VI, there were no statistically significant differences in the ranges of the malignancy rates among the four cytopathologists. However, there were significant differences in the ranges for categories I and III. Conclusions: Our findings suggest that institutions that use the BSRTC should regularly update their diagnostic criteria. We also propose that institutions issue an annual report of incidences and malignancy rates to help other clinicians improve the case management of patients with thyroid nodules.
참고문헌 (24)
- Cibas ES, "The Bethesda System For Reporting Thyroid Cytopathology", Am J Clin Pathol, 132, pp.658~665 (2009)
- Bongiovanni M, "The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis", Acta Cytol, 56, pp.333~339 (2012)
- Mondal SK, "The Bethesda system for reporting thyroid fine needle aspirates: a cytologic study with histologic follow-up", J Cytol, 30, pp.94~99 (2013)
- Jo VY, "Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology", Am J Clin Pathol, 134, pp.450~456 (2010)
- Yassa L, "Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation", Cancer, 111, pp.508~516 (2007)
- Yang J, "Fine-needle aspiration of thyroid nodules: a study of 4,703 patients with histologic and clinical correlations", Cancer, 111, pp.306~315 (2007)
- Nayar R, "The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference", Cancer, 117, pp.195~202 (2009)
- Theoharis CG, "The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution", Thyroid, 19, pp.1215~1223 (2009)
- Mufti ST, "The Bethesda System for Reporting Thyroid Cytopathology: a five-year retrospective review of one center experience", Int J Health Sci (Qassim), 6, pp.159~173 (2012)
- Baloch ZW, "Interinstitutional review of thyroid fine-needle aspirations: impact on clinical management of thyroid nodules", Diagn Cytopathol, 25, pp.231~234 (2001)
- Stamataki M, "The role of liquid-based cytology in the investigation of thyroid lesions", Cytopathology, 19, pp.11~18 (2008)
- Wu HH, "The Bethesda System for Reporting Thyroid Cytopathology: an experience of 1,382 cases in a community practice setting with the implication for risk of neoplasm and risk of malignancy", Diagn Cytopathol, 40, pp.399~403 (2012)
- 정찬권, "갑상샘 세침흡인세포검사 판독에 있어 베데스다 시스템의 적용", Journal of Pathology and Translational Medicine, 44(5), pp.521~527 (2010), 대한병리학회
- Layfield LJ, "Implications of the proposed thyroid fine-needle aspiration category of “follicular lesion of undetermined significance”: a five-year multi-institutional analysis", Diagn Cytopathol, 37, pp.710~714 (2009)
- Crippa S, "The Bethesda system for reporting thyroid fine-needle aspiration specimens", Am J Clin Pathol, 134, pp.343~344 (2010)
- Crowe A, "The impact of implementation of the Bethesda System for Reporting Thyroid Cytopathology on the quality of reporting, “risk” of malignancy, surgical rate, and rate of frozen sections requested for thyroid lesions", Cancer Cytopathol, 119, pp.315~321 (2011)
- Marchevsky AM, "Evidence-based evaluation of the risks of malignancy predicted by thyroid fine-needle aspiration biopsies", Diagn Cytopathol, 38, pp.252~259 (2010)
- Renshaw A, "An estimate of risk of malignancy for a benign diagnosis in thyroid fine-needle aspirates", Cancer Cytopathol, 118, pp.190~195 (2010)
- Gerhard R, "Inter- and intraobserver reproducibility of thyroid fine needle aspiration cytology: an analysis of discrepant cases", Cytopathology, 18, pp.105~111 (2007)
- Redman R, "Perceptions of diagnostic terminology and cytopathologic reporting of fine-needle aspiration biopsies of thyroid nodules: a survey of clinicians and pathologists", Thyroid, 16, pp.1003~1008 (2006)
- Bomeisl PE Jr, "Interinstitutional consultation in fine-needle aspiration cytopathology: a study of 742 cases", Cancer, 117, pp.237~246 (2009)
- Kocjan G, "The interobserver reproducibility of thyroid fine-needle aspiration using the UK Royal College of Pathologists’ classification system", Am J Clin Pathol, 135, pp.852~859 (2011)
- Clary KM, "Interobserver variability in the fine needle aspiration biopsy diagnosis of follicular lesions of the thyroid gland", Acta Cytol, 49, pp.378~382 (2005)
- Stelow EB, "Interobserver variability in thyroid fine-needle aspiration interpretation of lesions showing predominantly colloid and follicular groups", Am J Clin Pathol, 124, pp.239~244 (2005)