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Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience

Year 2019, Volume: 46 Issue: 3, 443 - 448, 16.09.2019
https://doi.org/10.5798/dicletip.620391

Abstract

Objective: Recent American Thyroid Association Guideline emphasizes that identifying the institutional malignancy risks for each Bethesda category is mandatory to achieve more accurate preoperative diagnosis in thyroid nodules. Aim of this study is to compare the preoperative fine needle aspiration biopsy (FNAB) and postoperative pathology results in a single institution in the era of the Bethesda System for Reporting thyroid Cytology (TBSRTC).  
Methods: The data of the patients who underwent FNAB and thyroidectomy between 2012 and 2018 were collected retrospectively. Patients who had available TBSRTC classification were included in the study. The malignancy risk of each TBSRTC classification was calculated.  
Results: One-hundred and forty-five patients were included. The mean age was 45.9±13.6. Preoperative FNAB categorization was TBSRTC I in 3 (2.1%) patients, TBSRTC II in 47 (32.4%) patients, TBSRTC III 16 (11%) patients, TBSRTC IV in 14 (9.7%) patients, TBSRTC V in 29 (20%) and VI in 36 (24.8%) patients. Postoperative pathology revealed malignancy in 66 (45.5%) of the patients. The malignancy risk was 33.3% in TBSRTC I, 4.3% in TBSRTC II, 31.3% in TBSRTC III, 42.9% in TBSRTC IV, 62.1% in TBSRTC V and 94.4% in TBSRTC VI categories.  
Conclusion: Our results were conformable with the malignancy risks reported by TBSRTC. Larger studies should be performed to validate and endorse nationwide standardization of the Bethesda system.  

References

  • 1. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008; 22: 901- 911. doi:10.1016/j.beem.2008.09.019.
  • 2. Jemal A, Siegel R, Xu J, Ward E. Cancer Statistics, 2010. CA Cancer J Clin. 2010; 60: 277-300. doi:10.3322/caac.20073.
  • 3. Yassa L, Cibas ES, Benson CB, et all. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007; 111: 508-516. doi:10.1002/cncr.23116.
  • 4. Bongiovanni, A. Spitale, W. C. Faquin, L. Mazzucchelli, and Z. W. Baloch, “The Bethesda system for reporting thyroid cytopathology: A meta-analysis,” Acta Cytologica. 2017; 61: 172.
  • 5. Patrizia S, Diana RE, Tommaso B, et all. A meta-analytic review of the Bethesda System for Reporting Thyroid Cytopathology: Has the rate of malignancy in indeterminate lesions been underestimated? Cancer Cytopathol. 2015. doi:10.1002/cncy.21605.
  • 6. D. Ozdemir, N. Bestepe, S. Faki, et all. “Comparison of thyroid fine needle aspiration biopsy results before and after implementation of Bethesda classification,” Cytopathology, 2017 Oct; 28: 400-6.
  • 7. P. S. Sullivan, S. L. Hirschowitz, P. C. Fung, and S. K. Apple, “The impact of atypia/follicular lesion of undetermined significance and repeat fine-needle aspiration: 5 years before and after implementation of the Bethesda System,” Cancer Cytopathol., 2014 Dec; 122: 866-72.
  • 8. E. Machała, J. Sopiński, I. Iavorska, and K. Kołomecki, “Correlation of Fine Needle Aspiration Cytology of Thyroid Gland with Histopathological Results,” Polish J. Surg., vol. 90, no. 5, pp. 1–5, 2018.
  • 9. H. Her-Juing Wu, C. Rose, and T. M. Elsheikh, “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., 2012 May; 40: 399-403.
  • 10. E. S. Cibas and S. Z. Ali, “The 2017 Bethesda System for Reporting Thyroid Cytopathology,” J. Am. Soc. Cytopathol., vol. 6, no. 6, pp. 217–222, 2017.
  • 11. R. L. Ferris, Z. Baloch, V. Bernet, et all. “American Thyroid Association Statement on Surgical Application of Molecular Profiling for Thyroid Nodules: Current Impact on Perioperative Decision Making,” Thyroid, vol. 25, no. 7, pp. 760–768, 2015.
  • 12. B. Haugen, E. K. Alexander, K. C. Bible, et all, “2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer,” The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer, 2016 Jan; 26: 1-133.
  • 13. Her-Juing Wu H, Rose C, Elsheikh TM. 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. DiagnCytopathol. 2012. doi:10.1002/dc.21754.
  • 14. Medina Chamorro FM, Calle JA, Stein JE, et all. Experience of the Implementation of Rapid On-Site Evaluation in Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules.CurrProblDiagnRadiol. 2018; 47: 220-4. doi:10.1067/j.cpradiol.2017.06.009.
  • 15. Kim Y-Y, Han K, Kim E-K, et all. Validation of the 2015 American Thyroid Association Management Guidelines for Thyroid Nodules With Benign Cytologic Findings in the Era of the Bethesda System. Am J Roentgenol. 2018; 210: 629-34. doi:10.2214/AJR.17.18507.
  • 16. Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S. Implications of the proposed thyroid fine-needle aspiration category of “follicular lesion of undetermined significance”: A five-year multi-institutional analysis. DiagnCytopathol. 2009; 37: 710- 4. doi:10.1002/dc.21093.
  • 17. Isik A, Firat D, Yilmaz I et al. A survey of current approaches to thyroid nodules and thyroid operations. Int J Surg. 2018 Jun; 54(Pt A): 100-4. doi: 10.1016/j.ijsu.2018.04.037
Year 2019, Volume: 46 Issue: 3, 443 - 448, 16.09.2019
https://doi.org/10.5798/dicletip.620391

Abstract

References

  • 1. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008; 22: 901- 911. doi:10.1016/j.beem.2008.09.019.
  • 2. Jemal A, Siegel R, Xu J, Ward E. Cancer Statistics, 2010. CA Cancer J Clin. 2010; 60: 277-300. doi:10.3322/caac.20073.
  • 3. Yassa L, Cibas ES, Benson CB, et all. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007; 111: 508-516. doi:10.1002/cncr.23116.
  • 4. Bongiovanni, A. Spitale, W. C. Faquin, L. Mazzucchelli, and Z. W. Baloch, “The Bethesda system for reporting thyroid cytopathology: A meta-analysis,” Acta Cytologica. 2017; 61: 172.
  • 5. Patrizia S, Diana RE, Tommaso B, et all. A meta-analytic review of the Bethesda System for Reporting Thyroid Cytopathology: Has the rate of malignancy in indeterminate lesions been underestimated? Cancer Cytopathol. 2015. doi:10.1002/cncy.21605.
  • 6. D. Ozdemir, N. Bestepe, S. Faki, et all. “Comparison of thyroid fine needle aspiration biopsy results before and after implementation of Bethesda classification,” Cytopathology, 2017 Oct; 28: 400-6.
  • 7. P. S. Sullivan, S. L. Hirschowitz, P. C. Fung, and S. K. Apple, “The impact of atypia/follicular lesion of undetermined significance and repeat fine-needle aspiration: 5 years before and after implementation of the Bethesda System,” Cancer Cytopathol., 2014 Dec; 122: 866-72.
  • 8. E. Machała, J. Sopiński, I. Iavorska, and K. Kołomecki, “Correlation of Fine Needle Aspiration Cytology of Thyroid Gland with Histopathological Results,” Polish J. Surg., vol. 90, no. 5, pp. 1–5, 2018.
  • 9. H. Her-Juing Wu, C. Rose, and T. M. Elsheikh, “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., 2012 May; 40: 399-403.
  • 10. E. S. Cibas and S. Z. Ali, “The 2017 Bethesda System for Reporting Thyroid Cytopathology,” J. Am. Soc. Cytopathol., vol. 6, no. 6, pp. 217–222, 2017.
  • 11. R. L. Ferris, Z. Baloch, V. Bernet, et all. “American Thyroid Association Statement on Surgical Application of Molecular Profiling for Thyroid Nodules: Current Impact on Perioperative Decision Making,” Thyroid, vol. 25, no. 7, pp. 760–768, 2015.
  • 12. B. Haugen, E. K. Alexander, K. C. Bible, et all, “2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer,” The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer, 2016 Jan; 26: 1-133.
  • 13. Her-Juing Wu H, Rose C, Elsheikh TM. 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. DiagnCytopathol. 2012. doi:10.1002/dc.21754.
  • 14. Medina Chamorro FM, Calle JA, Stein JE, et all. Experience of the Implementation of Rapid On-Site Evaluation in Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules.CurrProblDiagnRadiol. 2018; 47: 220-4. doi:10.1067/j.cpradiol.2017.06.009.
  • 15. Kim Y-Y, Han K, Kim E-K, et all. Validation of the 2015 American Thyroid Association Management Guidelines for Thyroid Nodules With Benign Cytologic Findings in the Era of the Bethesda System. Am J Roentgenol. 2018; 210: 629-34. doi:10.2214/AJR.17.18507.
  • 16. Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S. Implications of the proposed thyroid fine-needle aspiration category of “follicular lesion of undetermined significance”: A five-year multi-institutional analysis. DiagnCytopathol. 2009; 37: 710- 4. doi:10.1002/dc.21093.
  • 17. Isik A, Firat D, Yilmaz I et al. A survey of current approaches to thyroid nodules and thyroid operations. Int J Surg. 2018 Jun; 54(Pt A): 100-4. doi: 10.1016/j.ijsu.2018.04.037
There are 17 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Yasar Ozdenkaya This is me 0000-0003-0428-2511

Cenk Ersavas This is me 0000-0001-5134-1014

Oktay Olmuscelik This is me 0000-0002-9815-1848

Pelin Basim This is me 0000-0002-9452-9276

İrem Ozover This is me

Mehmet Seker This is me 0000-0002-6745-0159

Naciye Cigdem Arslan This is me 0000-0002-2282-7207

Publication Date September 16, 2019
Submission Date February 26, 2019
Published in Issue Year 2019 Volume: 46 Issue: 3

Cite

APA Ozdenkaya, Y., Ersavas, C., Olmuscelik, O., Basim, P., et al. (2019). Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. Dicle Tıp Dergisi, 46(3), 443-448. https://doi.org/10.5798/dicletip.620391
AMA Ozdenkaya Y, Ersavas C, Olmuscelik O, Basim P, Ozover İ, Seker M, Arslan NC. Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. diclemedj. September 2019;46(3):443-448. doi:10.5798/dicletip.620391
Chicago Ozdenkaya, Yasar, Cenk Ersavas, Oktay Olmuscelik, Pelin Basim, İrem Ozover, Mehmet Seker, and Naciye Cigdem Arslan. “Comparison of the Bethesda System Classification and Postoperative Cytology of Thyroid Nodules: A Single Center Experience”. Dicle Tıp Dergisi 46, no. 3 (September 2019): 443-48. https://doi.org/10.5798/dicletip.620391.
EndNote Ozdenkaya Y, Ersavas C, Olmuscelik O, Basim P, Ozover İ, Seker M, Arslan NC (September 1, 2019) Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. Dicle Tıp Dergisi 46 3 443–448.
IEEE Y. Ozdenkaya, “Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience”, diclemedj, vol. 46, no. 3, pp. 443–448, 2019, doi: 10.5798/dicletip.620391.
ISNAD Ozdenkaya, Yasar et al. “Comparison of the Bethesda System Classification and Postoperative Cytology of Thyroid Nodules: A Single Center Experience”. Dicle Tıp Dergisi 46/3 (September 2019), 443-448. https://doi.org/10.5798/dicletip.620391.
JAMA Ozdenkaya Y, Ersavas C, Olmuscelik O, Basim P, Ozover İ, Seker M, Arslan NC. Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. diclemedj. 2019;46:443–448.
MLA Ozdenkaya, Yasar et al. “Comparison of the Bethesda System Classification and Postoperative Cytology of Thyroid Nodules: A Single Center Experience”. Dicle Tıp Dergisi, vol. 46, no. 3, 2019, pp. 443-8, doi:10.5798/dicletip.620391.
Vancouver Ozdenkaya Y, Ersavas C, Olmuscelik O, Basim P, Ozover İ, Seker M, Arslan NC. Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. diclemedj. 2019;46(3):443-8.