Implementation of the Bethesda system for reporting the thyroid cytopathology: study on 5 729 cases from a cancer center
10.3760/cma.j.issn.1673-0860.2020.03.013
- VernacularTitle:甲状腺细胞病理学Bethesda报告系统的临床应用：肿瘤专科医院5 729例样本的回顾性分析
- Author:
Huiqin GUO
1
;
Huan ZHAO
;
Jian CAO
;
Linlin ZHAO
;
Yue SUN
;
Cong WANG
;
Zhihui ZHANG
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院病理科 100021
- Keywords:
Fine needle aspiration;
Thyroid;
Bethesda system;
Risk of malignancy;
Accuracy
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2020;55(3):258-262
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the data of the Bethesda system for reporting thyroid cytopathology applied in a comprehensive cancer center and to evaluate the diagnostic ability of fine needle aspiration (FNA).Methods:We retrospectively reviewed the medical records of 5 729 cases applying this reporting system at Cancer Hospital, Chinese Academy of Medical Sciences. The series were from 5 011 patients including 1 174 men and 3 837 women, and their median age was 45 years (range, 7-88 years). FNA results were correlated with final histological diagnosis after surgery and the accuracy of FNA diagnosis and the malignancy rates for each of categories were also analyzed.Results:Among 5 729 thyroid aspirates, aside from 456 (8.0%) cases with nondiagnostic or unsatisfactory (ND/UNS) outcomes, 1 055 (18.4%) cases were benign, 409 (7.1%) cases showed atypical of undetermined significance or follicular lesions with undetermined significance (AUS/FLUS), 80 (1.4%) cases were follicular neoplasm or suspicious for follicular neoplasm (FN/SFN), 982 (17.1%) cases were suspicious for malignancy (SUS), and 2 747 cases were malignant (47.9%). Of 5 729 cases, 3 239 had received thyroidectomies after FNA, 95.99% of them were proven histologically to be malignant, with following malignancy rates in individual FNA categories: ND/UNS 75.00%; benign 40.91%; AUS/FLUS 77.67%; FN/SFN 41.67%; SUS 96.86%; and malignant 99.96%. FNA predicted malignancy with sensitivity, specificity, accuracy, positive predictive value and negative predictive values of 98.8%, 60.5%, 97.7%, 98.9% and 59.1%, respectively.Conclusions:The data of the Bethesda reporting system indicates high proportion of malignant diagnosis and high risk of malignancy at all FNA diagnostic categories. FNA offers high diagnostic accuracy and positive predictive value for the diagnosis of thyroid diseases.
