Comparative analysis of cytological findings and diagnostic categories of independent сytopathologists

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Abstract


The article is devoted to the relevance of the application of the Bethesda classification system of interpretation of FNA in practice. In this study was investigated 104 cytological specimens of the thyroid gland from patients with var ious diseases of the thyroid gland. Revision of the cytological results was carried out by four highly qualified cytopathologists, working on the basis of three leading medical centers in the Russian Federation. Also, the respons es of each cytopathologist by diagnostic categories Bethesda Classification were compared. Statistical analysis showed that by the revision of the biopsy specimens there were no statistically significant differences between the ini tial cytologic findings and the results of independent cytopathologists. In analyzing the data, it was found that the fundamental error of cytological diagnosis were papillary carcinoma, medullary carcinoma, as well as “follicular neoplasm”. Comparing the results of histological examination with the responses of the cytopathologists was found that the major fault was the definition of papillary carcinoma and “follicular neoplasm”. The results suggest that Bethesda Classification allows to achieve the best results in the interpretation of the results of FNA, which leads to a more elaborate tactics of treatment of the patient.

About the authors

aspirant FGBU ENTs

doktor med. nauk, professor, zaveduyushchiy kliniko morfologicheskim otdelom FGBU “Meditsinskiy radiologicheskiy nauchnyy tsentr” MZ RF

kandidat med. nauk, vedushchiy nauchnyy sotrudnik otdeleniya terapii s gruppoy patologii metabo lizma i ozhireniya FGBU ENTs

kandidat med. nauk, zaveduyushchiy laboratoriey morfologiche skikh issledovaniy FGU SPKK “NMKhTs im. N.I. Pirogova”

sotrudnik laboratorii morfolo gicheskikh issledovaniy FGU SPKK “NMKhTs im. N.I. Pirogova”

Email: vanushko@hotmail.com
doktor med. nauk, glavnyy nauchnyy sotrudnik otdela khirurgii endokrinnykh organov FGBU ENTs

References

  1. Sharma R, Mondal A, Shankar LR et al. Differentiation of malig nant and benign solitary thyroid nodules using 30 and 120minute tc99m MIBI scans. Clin Nucl Med. 2004;29:534-537.
  2. Cesur M, Corapcioglu D, Bulut S et al. Comparison of palpation guided fineneedle aspiration biopsy to ultrasound-guided fine needle aspiration biopsy in the evaluation of thyroid nodules. Thyroid. 2006;16:555-561.
  3. Izquierdo R, Arekat MR, Knudson PE et al. Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice. Endocr Pract. 2006;12:609614.
  4. Cramer H. Fine needle aspiration cytology of the thyroid: an appraisal. Cancer Cytopathol. 2000;90:325-329.
  5. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006;12:63-103.
  6. Cooper DS, Doherty GM, Haugen BR et al. Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The American Thyroid Association Guidelines Taskforce. Thyroid. 2006;16:1-33.
  7. Theoharis CGA, Schofield KM, Hammers L et al. The Bethesda Thyroid Fine-Needle Aspiration Classification System: Year 1 at an Academic Institution. Thyroid. 2009;19:1215-1226.
  8. Gharib H, Papini E. Thyroid nodules: Clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am. 2007; 36:707-735.
  9. Vanderpump MPJ. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51.
  10. Cibas ES, Bibbo M. Thyroid FNA: Challenges and Opportunities. Acta Cytol. 2011;55:489-491.
  11. NCI Thyroid Fine Needle Aspiration State of Science Conference. Diagn Cytopathol. 2008;6:388-448.
  12. Baloch ZW, Livolsi VA, Asa SL et al. Diagnostic terminology and morphological criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute thyroid fine-needle aspiration state of the science conference. Diagn Cytopathol. 2008;36:425-433.
  13. Eedes CR, Wang HH. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations. Am J Clin Pathol. 2004;121:64-69.
  14. Kelly NP, Lim JC, DeJong S et al. Specimen adequacy and diagnostic specificity of ultrasound-guided fine needle aspirations of nonpalpable thyroid nodules. Diagn Cytopathol. 2006;34:188-190.
  15. Duek SD, Goldenberg D, Linn S et al. The role of fine-needle aspiration and intraoperative frozen section in the surgical management of solitary thyroid nodules. Surg Today. 2002;32:857-861.
  16. Eng CY, Quraishi MS, Bradley PJ. Management of Thyroid nodules in adult patients. In: Eng et al. Head & Neck Oncology. 2010;2:11-16.
  17. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost effec tiveness of on site evaluation of fine needle aspiration specimens. Review of 5,688 cases. Diagn Cytopathol. 2002;27:1-4.
  18. Thyroid cancer UK incidence statistics http://info.cancerre searchuk.org/cancerstats/types/thyroid/incidence/
  19. Thyroid cancer UK mortality statistics http://info.cancerre searchuk.org/cancerstats/types/thyroid/mortality/
  20. Дедов ИИ. Клинические рекомендации Российской ассоциации эндокринологов по диагностике и лечению узлового зоба. Матералы 3-го Всероссийского тиреоидологического конгресса. М., 2004; 5-12.
  21. Belfiore A, La Rosa GL. Fineneedle aspiration biopsy of the thyroid. J Endocrinol Metab Clin North Am. 2001;30:361-400.
  22. Wang C, Crapo LM. The epidemiology of thyroid disease and implication for screening. J Endocrinol Metab Clin North Am. 1997;26:189-218.
  23. Chehade JM, Silverberg AB, Kim J et al. Role of repeated fine-needle aspiration of thyroid nodules with benign cytologic features. Endocr Pract. 2001;7:237-243.
  24. Merchant SH, Izquierdo R, Khurana KK. Is repeated fine-needle aspiration cytology useful in the management of patients with benign nodular thyroid disease? Thyroid. 2000;10:489-492.
  25. Flanagan MB et al. Repeat thyroid nodule fine-needle aspiration in patients with initial benign cytologic results. Am J Clin Pathol. 2006;125(5):698-702.

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