BACKGROUND:Fine-needle aspiration cytology (FNAC) has become a well-established modality in the diagnosis, staging and follow-up of thyroid nodules. FNAC outcomes are routinely classified using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), facilitating appropriate clinical management. Bethesda categories III and IV encompass varying risks of malignancy. This retrospective study established a possible association between these cytological categories and malignancy rates in patients treated at a single institution. METHODS:Over a 6-year period, 11,627 FNAC procedures were performed on thyroid nodules. Of these, 814 (59.63%) patients were submitted to thyroidectomy. The nodules of 108 patients were classified as Bethesda category III and 47 patients as Bethesda category IV. Patient data were reviewed to establish a correlation between the FNAC results and the final histopathological analyses. RESULTS:The rates of malignancy among patients who underwent surgery were 25% for category III and 27.6% for category IV, with no significant differences between categories (p = 0.67). The pathological parameters of malignant nodules, namely tumour type, size, encapsulation, invasion into the thyroid capsule, extrathyroidal extension and lymphovascular invasion did not significantly differ between the groups (p > 0.05). CONCLUSIONS:This paper provides a more precise correlation of malignancy rates with thyroid nodules classified as Bethesda categories III and IV, as our findings are comparable to the literature, giving malignancy rates ranging from 10 to 30% for category III and 25-40% for category IV. Use of the BSRTC is heterogeneous across institutions, and there is some degree of subjectivity in the distinction between categories III and IV; therefore, it is crucial to estimate the rates of malignancy at each institution. Molecular assays are of increasing importance in determining the need for surgical intervention for thyroid lesions. Gene expression assays using FNAC material may demonstrate a high predictive value for cytologically indeterminate thyroid nodules diagnosed as Bethesda classes III and IV.

译文

背景:细针穿刺细胞学检查(FNAC)已成为甲状腺结节的诊断,分期和随访的公认方法。使用Bethesda甲状腺细胞病理学报告系统(BSRTC)对FNAC结局进行常规分类,以促进适当的临床管理。贝塞斯达(Bethesda)类别III和IV具有不同的恶性风险。这项回顾性研究确定了在单个机构接受治疗的患者中,这些细胞学类型与恶性程度之间可能存在关联。
方法:在6年的时间里,对甲状腺结节进行了11,627例FNAC手术。其中,有814例(59.63%)患者接受了甲状腺切除术。 108例患者的结节被分类为Bethesda III类,47例患者被分类为Bethesda IV类。审查患者数据以建立FNAC结果与最终组织病理学分析之间的相关性。
结果:接受手术的患者中,第三类为25%,第四类为27.6%,各类别之间无显着差异(p = 0.67)。两组的恶性结节的病理参数,即肿瘤类型,大小,包囊,浸润甲状腺囊,甲状腺外延伸和淋巴管浸润均无显着性差异(p> 0.05)。
结论:由于我们的发现与文献相当,本文提供了分类为贝塞斯达(Bethesda)III和IV类甲状腺结节的恶性肿瘤的更精确的相关性,得出III类的恶性率在10%至30%,25%的恶性率在25-40%第四类。 BSRTC的使用在各个机构之间是不同的,在III类和IV类之间的区分中存​​在一定程度的主观性。因此,估计每个机构的恶性肿瘤发病率至关重要。在确定对甲状腺病变进行手术干预的必要性方面,分子检测的重要性越来越高。使用FNAC材料进行的基因表达分析可能对诊断为贝塞斯达(Bethesda)III和IV类的细胞学不确定的甲状腺结节具有较高的预测价值。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录