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Tang J, Ma J, Xi X, Wang L, Li H, Huo S, Zhang B. Real-life utility of five-gene panel test in preoperative thyroid fine-needle aspiration biopsy: a large cohort of 740 patients study. Endocrine 2022; 80:552-562. [PMID: 36542267 DOI: 10.1007/s12020-022-03286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Fine-needle aspiration (FNA) biopsy is an effective method to discriminate malignant thyroid nodules but reaches indeterminate results in approximately 30% of cases. Molecular testing can improve the diagnostic accuracy of FNA. This study aimed to investigate the real-life utility of the five-gene panel testing in thyroid FNAs. METHODS 759 thyroid nodules from 740 patients under FNAs were retrospectively enrolled. Gene mutation information and clinical parameters, including age, gender, tumor size, and lymph node metastasis, were respectively recorded. Cytological results were classified based on The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). We analyzed mutational hotspots in BRAF, KRAS, NRAS, HRAS, and TERT genes from FNA specimens. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated to assess diagnostic performance. RESULTS We identified 549 five-gene mutations in 759 nodules (72.3%), and the mutation frequency increased from the lower TBSRTC category to the upper category. BRAF.p.V600E showed the highest mutation incidence (71.3%) in the five-gene panel, correlated with the small to medium diameter (p = 0.008, p = 0.012) and high cytological categories (p < 0.001). The sensitivity, specificity, PPV, NPV, and accuracy of the combination of FNA cytology and five-gene detection were 96.83%, 100%, 100%, 42.86%, and 96.90%, respectively. CONCLUSIONS The mutation frequency of the five-gene panel is 72.3% in thyroid FNAs. BRAF.p.V600E has the highest alteration rate, which is closely associated with tumor size and cytological results. The five-gene panel can improve the sensitivity and accuracy of FNA cytology, which may represent a valid adjunct technique in distinguishing thyroid nodules.
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Affiliation(s)
- Jiajia Tang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jiaojiao Ma
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xuehua Xi
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Liangkai Wang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, China
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Huilin Li
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, 100029, China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Shirui Huo
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Bo Zhang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
- Department of Ultrasound, China-Japan Friendship Hospital, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine of Chinese Academy of Medical Sciences, Beijing, 100029, China.
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Perdana AB, Putri RI, Rachmawati R, Andinata B, Brahma B. Clinical Utility of BRAF, NRAS, and TERT Promoter Mutation in Preoperative Thyroid Fine-Needle Aspiration Biopsy: A Diagnostic Study From Dharmais Cancer Hospital. Asian Pac J Cancer Prev 2020; 21:3267-3277. [PMID: 33247684 PMCID: PMC8033131 DOI: 10.31557/apjcp.2020.21.11.3267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: Molecular testing of thyroid nodules becomes important for improving the accuracy of fine-needle aspiration biopsy (FNAB). This study aimed to investigate the diagnostic utility of BRAF, NRAS, and TERT promoter mutation in thyroid nodules at Dharmais Cancer Hospital. Methods: We performed a prospective diagnostic study involving 50 patients with thyroid nodules who needed surgery between September 2013 and August 2014. Mutational hotspots in BRAF exon 15, NRAS exon 3, and TERT promoter region were analyzed by Sanger sequencing from FNAB specimens. Cytology and molecular data were compared to histopathology results. Results: Of the 50 cases included in the analysis, 39 cases (78%) were thyroid malignancies. Mutations of BRAF, NRAS, and TERT promoter were detected in 31% (12/39), 18% (7/39), and 13% (5/39) cases, respectively. BRAF and NRAS mutations were found mutually exclusive, while all of TERT promoter mutation was found coexistent either with BRAF (40%) or NRAS (60%). The combination of FNAB cytology and molecular testing resulted in 69% sensitivity, 100% specificity, 100% positive predictive value, 48% negative predictive value, and 76% accuracy. Conclusion: Molecular testing of BRAF, NRAS, and TERT mutations improve the sensitivity of thyroid FNAB and is beneficial for more definitive treatment in selective cases. However, the NPV is relatively low to avoid the need for diagnostic surgery. Therefore, further studies to identify more sensitive methods and more comprehensive molecular markers in the diagnosis of thyroid nodules are needed.
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Affiliation(s)
- Adhitya Bayu Perdana
- Department of Research and Development, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia
| | - Rizky Ifandriani Putri
- Department of Anatomical Pathology, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia
| | - Rachmawati Rachmawati
- Surgical Oncology Study Program, Department of Surgery, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Bob Andinata
- Department of Surgical Oncology, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia
| | - Bayu Brahma
- Department of Surgical Oncology, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia
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Mohebbi M, Dehaki MG, Mozaffari M. Comparison between ultrasonographic findings and fine needle aspiration cytology in differentiating malignant and benign thyroid nodules. Eur J Transl Myol 2019; 29:8354. [PMID: 31579481 PMCID: PMC6767841 DOI: 10.4081/ejtm.2019.8354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/05/2019] [Indexed: 11/24/2022] Open
Abstract
The purpose of research was comparing the ultrasound (US) features and fine-needle aspiration cytology (FNAC) in detecting the thyroid nodules in clinical practice. A cross-sectional analytical study retrospectively reviewed the US and FNAC findings for a total of 170 thyroid nodules. The US features that we compared included echogenicity, calcifications, shape, halo and Doppler, between 2017 and 2018. Totally, 170 nodules of thyroid were studied, which contained 72 (42.4%) benign and 98 (57.6%) malignant thyroid nodules. The sonographic features were significantly associated with malignancy such as microcalcification (97.0%), hyperechogenicity (91.5%), wider than taller shape (98.0%), absent halo (90.9%) and positive Doppler (78.0%) (P < 0.01). The altogether accuracies of calcification, echogenicity, shape, halo, and Doppler were 0.96, 0.92, 0.97,0.82 and 0.82, respectively. Our data suggest that US features could be a good sonographic criterion for recommending FNA cytology with follow‐up thyroid sonography and FNA.
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Affiliation(s)
- Mahdi Mohebbi
- Department of Internal Medicine, School of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Mehrzad Gholampour Dehaki
- Department of Internal Medicine, School of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Mahsa Mozaffari
- Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
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4
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Mais DD, Crothers BA, Davey DD, Natale KE, Nayar R, Souers RJ, Blond BJ, Hackman S, Tworek JA. Trends in Thyroid Fine-Needle Aspiration Cytology Practices: Results From a College of American Pathologists 2016 Practice Survey. Arch Pathol Lab Med 2019; 143:1364-1372. [PMID: 31100017 DOI: 10.5858/arpa.2018-0429-cp] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The College of American Pathologists periodically surveys laboratories to determine changes in cytopathology practices. We report the results of a 2016 survey concerning thyroid fine-needle aspiration (FNA). OBJECTIVE.— To provide a cross-sectional survey of thyroid cytology practices in 2016. DESIGN.— In 2016, a survey was sent to 2013 laboratories participating in the College of American Pathologists Non-Gynecologic Cytology Education Program (NGC-A) requesting data from 2015-2016 on several topics relating to thyroid FNA. RESULTS.— A total of 878 laboratories (43.6% of 2013) replied to the survey. Radiologists performed the most thyroid FNA procedures in most laboratories (70%; 529 of 756), followed by endocrinologists (18.7%; 141 of 756), and most of these were performed under ultrasound guidance (92.1%; 699 of 759). A total of 32.6% of respondents (251 of 769) provided feedback on unsatisfactory rates for nonpathology providers who performed FNA. Intraprocedural adequacy assessment was primarily performed by attending pathologists (77.4%; 490 of 633) or cytotechnologists (28.4%; 180 of 633). Most laboratories used the Bethesda System for Reporting Thyroid Cytopathology (89.8%; 701 of 781) and performed molecular testing based on clinician request (68.1%; 184 of 270) rather than FNA diagnosis. Correlation of thyroid excisions with prior cytology results most often occurred retrospectively (38.4%; 283 of 737) and was used for pathologist interpretive quality assurance purposes. CONCLUSIONS.— These survey results offer a snapshot of national thyroid FNA cytology practices in 2016 and indicate that standardized cytology terminology is commonly used; pathologists perform most immediate adequacy assessments for thyroid FNA; laboratories use correlation statistics to evaluate pathologists' performance; and molecular tests are increasingly requested for indeterminate interpretations, but reflex molecular testing is rare.
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Affiliation(s)
- Daniel D Mais
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Barbara A Crothers
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Diane Davis Davey
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Kristen E Natale
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Ritu Nayar
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Rhona J Souers
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Barbara J Blond
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Sarah Hackman
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
| | - Joseph A Tworek
- From the Gynecologic & Breast Pathology and Cytopathology Divisions, Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, University of Texas Health Sciences Center University Hospital, San Antonio (Drs Mais and Hackman); the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Davey); Anatomic Pathology, Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Natale); the Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois (Dr Nayar); Biostatistics and Surveys (Ms Souers) and Surveys, Cytopathology (Ms Blond), College of American Pathologists, Northfield, Illinois; and the Department of Pathology, St Joseph Mercy Hospital, Ann Arbor, Michigan (Dr Tworek)
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5
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Kumari KA, Jadhav PD, Prasad C, Smitha NV, Jojo A, Manjula VD. Diagnostic Efficacy of Ultrasound-Guided Fine Needle Aspiration Combined with the Bethesda System of Reporting. J Cytol 2019; 36:101-105. [PMID: 30992645 PMCID: PMC6425777 DOI: 10.4103/joc.joc_168_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Image-guided fine needle aspiration cytology (FNAC) is emerging as an important diagnostic tool in the evaluation of thyroid swellings. Aim: This study aims to assess the efficacy of ultrasound (US)-guided FNAC combined with “The Bethesda system' of reporting as a primary screening test for all thyroid lesions. Settings and Design: A prospective cohort study was made and all the US-guided FNACs done were followed up to find out the histopathological diagnoses wherever surgery was done. Materials and Methods: In all, 1050 patients who underwent US-guided FNAC were studied during a period of 1 year. Age, sex, cytological features, and histological diagnoses were analyzed. Statistical analyses of all the findings were done to derive conclusions. Results: Of the 1050 patients, only 10.5% underwent surgery. Higher than expected rate (as per the Bethesda system) of malignancy was noted with the so-called grey zone lesions. The test results revealed a high level of sensitivity, specificity, and diagnostic accuracy. Conclusion: The study showed that The Bethesda System of Reporting Thyroid Cytology provides effective communication between clinician and pathologists thereby enabling clear management strategies. We also concluded that US-guided FNACs offer better results compared with palpation-guided FNACs.
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Affiliation(s)
- K Ajitha Kumari
- Department of Pathology, Believers Church Medical College, Thiruvalla, Kerala, India
| | - Poonam D Jadhav
- Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Chaya Prasad
- Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - N V Smitha
- Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Annie Jojo
- Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - V D Manjula
- Department of Community Medicine, Government Medical College, Idukki, Kerala, India
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6
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Deal SB, D'Angelica MI, Hawkins WG, Pucci M, Ujiki M, Brunt LM, Wexner S, Alseidi AA. Synoptic operative reporting for laparoscopic cholecystectomy and pancreaticoduodenectomy: A multi institutional pilot study evaluating completeness and surgeon perceptions. Am J Surg 2018; 216:935-940. [PMID: 29937324 DOI: 10.1016/j.amjsurg.2018.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Synoptic operative reports (SOR) are more accurate than dictated operative reports (DOR) in a few single institution experiences. We sought to examine the completeness of SOR for laparoscopic cholecystectomy (LC) and pancreaticoduodenectomy (PD) in a multi institutional pilot study. METHODS Six institutions participated in SOR submission via a web-based survey. One institution collected DOR and case matched historical dictated operative reports (HOR) for subset analysis. A checklist evaluated completeness of all reports. A post-survey assessed participant opinions. RESULTS 40 PD SORs were 98.5% complete and 35 LC SORs were 99.7% complete. Single institution subset analysis respective percent complete were: 11 PD SORs 99%, DORs 70% and HORs 74% and 14 LC SORs 99.7%, DORs 76%, and HORs 75%. Post-survey results yielded 10 PD and 24 LC responses. An overwhelming majority agreed that SOR were easy to use and would prefer to use SOR compared to DOR. CONCLUSION SOR are more complete than both study associated DOR and HOR. The majority of surgeons indicated their preference for SOR and their willingness to use them.
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Affiliation(s)
- Shanley B Deal
- Virginia Mason Medical Center, General Thoracic and Vascular Surgery, 1100 9th Avenue, Seattle, WA, 98101, USA.
| | | | - William G Hawkins
- Washington University St. Louis, 660 South Euclid Ave, Box 8109, Saint Louis, MO, 63110, USA
| | - Michael Pucci
- Jefferson University Hospital, 1100 Walnut St, 5th Floor, Philadelphia, PA, 19107, USA
| | - Michael Ujiki
- NorthShore University Health System, 1000 Central St #800, Evanston, IL, 60201, USA
| | - L Michael Brunt
- Washington University St. Louis, 660 South Euclid Ave, Box 8109, Saint Louis, MO, 63110, USA
| | - Steven Wexner
- Cleveland Clinic, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Adnan A Alseidi
- Virginia Mason Medical Center, General Thoracic and Vascular Surgery, 1100 9th Avenue, Seattle, WA, 98101, USA
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Awasthi P, Goel G, Khurana U, Joshi D, Majumdar K, Kapoor N. Reproducibility of "The Bethesda System for Reporting Thyroid Cytopathology:" A Retrospective Analysis of 107 Patients. J Cytol 2018; 35:33-36. [PMID: 29403167 PMCID: PMC5795725 DOI: 10.4103/joc.joc_215_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives: Fine-needle aspiration cytology (FNAC) has emerged as an indispensable tool to discriminate thyroid lesions into benign or malignant for appropriate management. The need for simplicity of communication and standardization of terminology for thyroid FNAC reporting led to introduction of “The Bethesda system for reporting Thyroid Cytopathology” (TBSRTC) in a conference held at the National Cancer Institute in 2007. This study aims at establishing the reproducibility of TBSRTC for diagnosing thyroid lesions. Materials and Methods: The present study comprised thyroid FNAC from 107 patients retrospectively over a period of 1.5 year (June 2013 to December 2014), which were reviewed by two trained cytopathologists and re-categorized according to TBSRTC. The interobserver variation and reproducibility of the reporting system was statistically assessed using Cohen's kappa. Results: The cytopathologists were in agreement in 98 out of 107 cases (91.5%). Maximum concordance was noted in benign category (91 of 96 cases; 92.85%), followed by 2 cases each in nondiagnostic/unsatisfactory (ND/US) and follicular neoplasm/suspicious for follicular neoplasm (FN/SFN) category (2.04% each) and 1 case each in atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), suspicious for malignancy (SUS), and malignant category (1.02% each). The highest diagnostic disagreement was noted among ND/US and benign and benign and FN/SFN categories. Conclusion: The utilization of TBSRTC for reporting thyroid cytology should be promoted in our country because it provides a homogeneous, standardized, and unanimous terminology for cytological diagnosis of thyroid lesions. The present study could substantiate the diagnostic reproducibility of this system.
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Affiliation(s)
- Pragati Awasthi
- Department of Pathology and Laboratory Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Garima Goel
- Department of Pathology and Laboratory Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Ujjawal Khurana
- Department of Pathology, People's Medical College, Bhopal, Madhya Pradesh, India
| | - Deepti Joshi
- Department of Pathology and Laboratory Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Kaushik Majumdar
- Department of Pathology, G B Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India
| | - Neelkamal Kapoor
- Department of Pathology and Laboratory Medicine, AIIMS, Bhopal, Madhya Pradesh, India
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8
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Kakudo K, Higuchi M, Hirokawa M, Satoh S, Jung CK, Bychkov A. Thyroid FNA cytology in Asian practice-Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas. Cytopathology 2017; 28:455-466. [DOI: 10.1111/cyt.12491] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 01/31/2023]
Affiliation(s)
- K. Kakudo
- Department of Pathology; Kindai University Faculty of Medicine; Ikoma Japan
| | - M. Higuchi
- Department of Clinical Laboratory; Kuma Hospital; Kobe Japan
| | - M. Hirokawa
- Department of Diagnostic Pathology; Kuma Hospital; Kobe Japan
| | - S. Satoh
- Endocrine Surgery; Yamashita Thyroid Hospital; Fukuoka Japan
| | - C. K. Jung
- Department of Hospital Pathology; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - A. Bychkov
- Department of Pathology; Faculty of Medicine; Chulalongkorn University; Bangkok Thailand
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9
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Kim M, Park HJ, Min HS, Kwon HJ, Jung CK, Chae SW, Yoo HJ, Choi YD, Lee MJ, Kwak JJ, Song DE, Kim DH, Lee HK, Kim JY, Hong SH, Sohn JS, Lee HS, Park SY, Hong SW, Shin MK. The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists. J Pathol Transl Med 2017; 51:410-417. [PMID: 28609825 PMCID: PMC5525040 DOI: 10.4132/jptm.2017.04.05] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 01/21/2023] Open
Abstract
Background The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. Methods Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed. Results Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%. Conclusions More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.
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Affiliation(s)
- Mimi Kim
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Hyo Jin Park
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye Sook Min
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Hyeong Ju Kwon
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Pathology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chan Kwon Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Ju Yoo
- Department of Pathology, Thyroid Center, Daerim St. Mary's Hospital, Seoul, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Mi Ja Lee
- Department of Pathology, Chosun University School of Medicine, Gwangju, Korea
| | - Jeong Ja Kwak
- Department of Pathology, Soon Chun Hyang University Hospital, Bucheon, Korea
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hoon Kim
- Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye Kyung Lee
- Department of Pathology, Eulji University School of Medicine, Daejeon, Korea
| | - Ji Yeon Kim
- Department of Pathology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sook Hee Hong
- Department of Pathology, Seegene Medical Foundation, Busan, Korea
| | - Jang Sihn Sohn
- Department of Pathology, Konyang University Hospital, Daejeon, Korea
| | - Hyun Seung Lee
- Department of Pathology, Yangji General Hospital, Seoul, Korea
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soon Won Hong
- Department of Pathology, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Kyung Shin
- Department of Pathology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
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10
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Brister KJ, Singh RS, Wang HH. Reporting thyroid FNA before and after implementation of the Bethesda system-one institution's experience. Diagn Cytopathol 2014; 43:28-31. [DOI: 10.1002/dc.23182] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/14/2014] [Accepted: 05/09/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Kathriel J. Brister
- Beth Israel Deaconess Medical Center; Department of Pathology; Boston Massachusetts
| | - Remmi S. Singh
- Northside Hospital; Department of Pathology; Atlanta Georgia
| | - Helen H. Wang
- Beth Israel Deaconess Medical Center; Department of Pathology; Boston Massachusetts
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