Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis
Öz
Purpose: The thyroid fine needle aspiration cytology (FNAC) is a fast, reliable, and economical method for the interpretation of thyroid nodules. This method contributes to the later management of patients and reduces unnecessary surgical interventions. This study aimed to demonstrate the contribution of bedside adequacy assessment during FNAC to the accuracy rates of cytological competence and final histological diagnosis.
Materials and Methods: The study included 443 patients who underwent FNAC in a university hospital between 2012 and 2015. Correlations between the histological diagnosis categories of patients who had and who did not have bedside adequacy assessment were compared per sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy.
Results: As a result of comparison of cytological and histopathological diagnoses, 30.7% sensitivity, 75% specificity, 50% positive predictive value, 57.1% negative predictive value and 55.1% diagnostic accuracy were found in the group with bedside adequacy assesment. Whereas in the group without bedside adequacy assessment, 50% sensitivity, 69.2% specificity, 42.8% positive predictive value, 75% negative predictive value, and 63.1% diagnostic accuracy were found
Conclusion: Bedside adequacy assessment increases the cytological adequacy proportion, but does not contribute to the diagnostic accuracy rate.
Anahtar Kelimeler
Bedside Adequacy Assessment Thyroid Fine-Needle Aspiration Cytology
Kaynakça
- Popoveniuc, Geanina, and Jacqueline Jonklaas. "Thyroid nodules." Medical Clinics of North America 96.2 (2012): 329-349.
- Dean, Diana S., and Hossein Gharib. "Epidemiology of thyroid nodules." Best Practice & Research Clinical Endocrinology & Metabolism 22.6 (2008): 901-911.
- Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME, et al. 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: 63-102
- Frates, Mary C., et al. "Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography." The Journal of Clinical Endocrinology & Metabolism 91.9 (2006): 3411-3417.
- DeMay RM. The Art and Science of Cytopathology, 2nd edn. Chicago, IL: ASCP Press; 2011.
- Orell SV, Sterrett GF (eds). Orell and Sterrett’s Fine Needle Aspiration Cytology. 5th edn. Edinburgh: Churchill Livingstone Elsevier; 2012.
- De Koster, E. J., Kist, J. W., Vriens, M. R., Borel Rinkes, I. H. M., Valk, G. D., & De Keizer, B. (2016). Thyroid ultrasound-guided fine-needle aspiration: The positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate. Acta cytologica, 60(1), 39-45.
- Hegedus, L. Clinical practice. The thyroid nodule. N Engl J Med 351, 1764–1771, 2004.
- Simsek, G. G., Ertuğrul, D. T., Guresci, S., & Şimşek, H. (2013). Is there a role for on-site evaluation of thyroid fine needle aspiration to reduce the nondiagnostic rate?. Endocrine pathology, 24(2), 57-61.
- Danese, D., Sciacchitano, S., Farsetti, A., Andreoli, M. & Pontecorvi, A. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 8, 15–21, 1998.
- Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017 Nov;27(11):1341-1346. doi: 10.1089/thy.2017.0500. PubMed PMID: 29091573.
- Shield, P. W., Cosier, J., Ellerby, G., Gartrell, M., & Papadimos, D. (2014). Rapid onsite evaluation of fine-needle aspiration specimens by cytology scientists: a review of 3032 specimens. Cytopathology, 25(5), 322-329.
- İnan G., Sert S., Bircan S. ve ark. Tiroid lezyonlarında tiroid ince iğne aspirasyon biyopsisi ve histopatoloji sonuçlarının karşılaştırılması. SDÜ Tıp Fakültesi Dergisi, 2006. 13(4). (27-31)
- Goldstein RE, Netterville JL, Burkey B, et al. Implications of follicular neoplasms, atypia, and lesions suspicious for malignancy diagnosed by fine-needle aspiration of thyroid nodules. Ann Surg 2002; 235: 656-62; discussion 62-4.
- Eedes, Christopher R., and Helen H. Wang. "Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations." American journal of clinical pathology 121.1 (2004): 64-69.
- Ali SZ, Cibas ES. Tiroid Sitopatolojisi Raporlamasında Bethesda Sistemi. (Çev.Ed: Önder S) s. 1-167, Nobel Tıp Kitabevi, İstanbul, 2012.
- Layfield LJ, Abrams J, Cochand-Priollet B, Evans D, Gharib H, Greenspan F, Henry M, LiVolsi V, Merino M, Michael CW, Wang H, Wells SA. Post-thyroid FNA Testing and Treatment options: A Synopsis of the National Cancer Institue Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol 36(6):442-8, 2008.
- Ghofrani, M., Beckman, D., & Rimm, D. L. (2006). The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience. Cancer Cytopathology, 108(2), 110-113.
- Crothers, B. A., Henry, M. J., & Auger, M. (2008). NCI Thyroid Fine-Needle Aspiration State of the Science Conference: a dialogue on thyroid disease reporting and management. CAP Today, 22, 48-58.
- Cowling, P., Chandra, A., & Giles, T. (2009). Guidance on the reporting of thyroid cytology specimens. Royal College of Pathologists.
- Baloch, Z.W., Tam, D., Langer, J., Mandel, S., LiVolsi, V. A., &Gupta, P. K. (2000). Ultrasound guided fine needle aspiration biopsy of the thyroid: Role of onsite assessment and multiple cytologic preparations. Diagnostic cytopathology, 23(6), 425-429.
- Baloch, Z.W., Sack, M.J., Yu, G.H., Lıvolsı, V. A., & Gupta, P. K. (1998). Fine-needle aspiration of thyroid: an institutional experience. Thyroid, 8(7), 565-569.
- Schmidt, R. L., Witt, B. L., Lopez-Calderon, L. E., & Layfield, L. J. (2013). The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology. American journal of clinical pathology, 139(3), 300-308.
- Önver, H., Özbey, A. O., Duymuş, M., Yılmaz, Ö., & Koşar, P. N. (2013). Tiroit nodüllerinin ultrasonografik, sitolojik ve histopatolojik bulgularının incelenmesi. Kafkas J Med Sci, 3(2), 80-7.
- Yang J, Schnadig V, Logrono R, et al. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer 2007; 111: 306-15
- Bongiovanni, M., Spitale, A., Faquin, W. C., Mazzucchelli, L., & Baloch, Z. W. (2012). The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta cytologica, 56(4), 333-339.
- Theoharis, C. G., Schofield, K. M., Hammers, L., Udelsman, R., & Chhieng, D. C. (2009). The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid, 19(11), 1215-1223.
- Her‐Juing Wu, H., Rose, C., & Elsheikh, T. M. (2012). 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. Diagnostic cytopathology, 40(5), 399-403.
- V. L. Ramesh, R. Ramu, C. Narayana Murthy. ”Accuracy of Fine Needle Aspiration Cytology of Thyroid Swellings”. Journal of Evidence based Medicine and Healthcare; Volume 1, Issue 16, December 22, 2014; Page: 2074-2078.
- Jo, V, Stelow E., Dustin S. ve ark. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for reporting thyroid cytopathology. American Journal of Clinical Pathology, 2010. 134(3): p. 450-456.
- Yassa L.,Cibas E. S., Benson C. B. ve ark. Long‐term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer Cytopathology, 2007. 111(6): p. 508-516.
- Muratli, A., Erdogan, N., Sevim, S., Unal, I., & Akyuz, S. (2014). Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. Journal of Cytology, 31(2), 73.
- Bagga, P. K., & Mahajan, N. C. (2010). Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it?. Indian journal of cancer, 47(4), 437.
- Pandey, P., Dixit, A., & Mahajan, N. C. (2012). Fine-needle aspiration of the thyroid: A cytohistologic correlation with critical evaluation of discordant cases. Thyroid Research and practice, 9(2), 32.
- Amrikachi M, Ramzy I, Rubenfeld S, et al. Accuracy of fineneedle aspiration of thyroid. Arch Pathol Lab Med 2001; 125: 484-8
Tiroid sitolojisinde hasta başı yeterlilik çalışmasının sitolojik yeterlilik ve kalıcı histopatolojik tanıya etkisi
Öz
Amaç: Tiroid ince iğne aspirasyon sitolojisi (İİAS), tiroid nodüllerinin değerlendirilmesi için; hızlı, güvenilir, ekonomik bir yöntemdir. Bu yöntem hastaların ileri dönemde yönetimine katkı sağlamakta ve gereksiz cerrahi uygulamaları azaltmaktadır. Bu çalışmada İİAS sırasında, hasta başında yeterlilik değerlendirilmesinin, sitolojik yeterlilik ve histolojik kesin tanıda doğruluk oranlarına ne kadar katkısı olduğunu göstermek amaçlandı.
Gereç ve Yöntem: Çalışmaya, 2012-2015 yılları arasında, bir üniversite hastanesinde İİAS uygulanmış 443 hasta dâhil edilmiştir. Hasta başında yeterlilik değerlendirilen ve değerlendirilmeyen olguların histolojik tanı kategorileriyle korelasyonu; duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörü değeri, tanısal doğruluk oranlarına göre karşılaştırılmıştır.
Bulgular: Sitolojik ve histopatolojik tanıların karşılaştırılması sonucunda, hasta başı yeterlilik değerlendirilen grupta, duyarlılık %30,7, özgüllük %75, pozitif öngörü değeri %50, negatif öngörü değeri %57,1, tanısal doğruluk %55,1 olarak bulunmuştur. Hasta başı yeterlilik değerlendirilmeyen grupta ise duyarlılık %50, özgüllük %69,2, pozitif öngörü değeri %42,8 negatif öngörü değeri %75, tanısal doğruluk %63,1 olarak bulunmuştur.
Sonuç: Hasta başı yeterlilik değerlendirilmesi, sitolojik yeterlilik oranını arttırır, ancak tanısal doğruluk oranına katkıda bulunmaz.
Anahtar Kelimeler
Hasta başı yeterlilik değerlendirilmesi Tiroid İnce iğne aspirasyon sitolojisi
Kaynakça
- Popoveniuc, Geanina, and Jacqueline Jonklaas. "Thyroid nodules." Medical Clinics of North America 96.2 (2012): 329-349.
- Dean, Diana S., and Hossein Gharib. "Epidemiology of thyroid nodules." Best Practice & Research Clinical Endocrinology & Metabolism 22.6 (2008): 901-911.
- Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME, et al. 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: 63-102
- Frates, Mary C., et al. "Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography." The Journal of Clinical Endocrinology & Metabolism 91.9 (2006): 3411-3417.
- DeMay RM. The Art and Science of Cytopathology, 2nd edn. Chicago, IL: ASCP Press; 2011.
- Orell SV, Sterrett GF (eds). Orell and Sterrett’s Fine Needle Aspiration Cytology. 5th edn. Edinburgh: Churchill Livingstone Elsevier; 2012.
- De Koster, E. J., Kist, J. W., Vriens, M. R., Borel Rinkes, I. H. M., Valk, G. D., & De Keizer, B. (2016). Thyroid ultrasound-guided fine-needle aspiration: The positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate. Acta cytologica, 60(1), 39-45.
- Hegedus, L. Clinical practice. The thyroid nodule. N Engl J Med 351, 1764–1771, 2004.
- Simsek, G. G., Ertuğrul, D. T., Guresci, S., & Şimşek, H. (2013). Is there a role for on-site evaluation of thyroid fine needle aspiration to reduce the nondiagnostic rate?. Endocrine pathology, 24(2), 57-61.
- Danese, D., Sciacchitano, S., Farsetti, A., Andreoli, M. & Pontecorvi, A. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 8, 15–21, 1998.
- Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017 Nov;27(11):1341-1346. doi: 10.1089/thy.2017.0500. PubMed PMID: 29091573.
- Shield, P. W., Cosier, J., Ellerby, G., Gartrell, M., & Papadimos, D. (2014). Rapid onsite evaluation of fine-needle aspiration specimens by cytology scientists: a review of 3032 specimens. Cytopathology, 25(5), 322-329.
- İnan G., Sert S., Bircan S. ve ark. Tiroid lezyonlarında tiroid ince iğne aspirasyon biyopsisi ve histopatoloji sonuçlarının karşılaştırılması. SDÜ Tıp Fakültesi Dergisi, 2006. 13(4). (27-31)
- Goldstein RE, Netterville JL, Burkey B, et al. Implications of follicular neoplasms, atypia, and lesions suspicious for malignancy diagnosed by fine-needle aspiration of thyroid nodules. Ann Surg 2002; 235: 656-62; discussion 62-4.
- Eedes, Christopher R., and Helen H. Wang. "Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations." American journal of clinical pathology 121.1 (2004): 64-69.
- Ali SZ, Cibas ES. Tiroid Sitopatolojisi Raporlamasında Bethesda Sistemi. (Çev.Ed: Önder S) s. 1-167, Nobel Tıp Kitabevi, İstanbul, 2012.
- Layfield LJ, Abrams J, Cochand-Priollet B, Evans D, Gharib H, Greenspan F, Henry M, LiVolsi V, Merino M, Michael CW, Wang H, Wells SA. Post-thyroid FNA Testing and Treatment options: A Synopsis of the National Cancer Institue Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol 36(6):442-8, 2008.
- Ghofrani, M., Beckman, D., & Rimm, D. L. (2006). The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience. Cancer Cytopathology, 108(2), 110-113.
- Crothers, B. A., Henry, M. J., & Auger, M. (2008). NCI Thyroid Fine-Needle Aspiration State of the Science Conference: a dialogue on thyroid disease reporting and management. CAP Today, 22, 48-58.
- Cowling, P., Chandra, A., & Giles, T. (2009). Guidance on the reporting of thyroid cytology specimens. Royal College of Pathologists.
- Baloch, Z.W., Tam, D., Langer, J., Mandel, S., LiVolsi, V. A., &Gupta, P. K. (2000). Ultrasound guided fine needle aspiration biopsy of the thyroid: Role of onsite assessment and multiple cytologic preparations. Diagnostic cytopathology, 23(6), 425-429.
- Baloch, Z.W., Sack, M.J., Yu, G.H., Lıvolsı, V. A., & Gupta, P. K. (1998). Fine-needle aspiration of thyroid: an institutional experience. Thyroid, 8(7), 565-569.
- Schmidt, R. L., Witt, B. L., Lopez-Calderon, L. E., & Layfield, L. J. (2013). The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology. American journal of clinical pathology, 139(3), 300-308.
- Önver, H., Özbey, A. O., Duymuş, M., Yılmaz, Ö., & Koşar, P. N. (2013). Tiroit nodüllerinin ultrasonografik, sitolojik ve histopatolojik bulgularının incelenmesi. Kafkas J Med Sci, 3(2), 80-7.
- Yang J, Schnadig V, Logrono R, et al. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer 2007; 111: 306-15
- Bongiovanni, M., Spitale, A., Faquin, W. C., Mazzucchelli, L., & Baloch, Z. W. (2012). The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta cytologica, 56(4), 333-339.
- Theoharis, C. G., Schofield, K. M., Hammers, L., Udelsman, R., & Chhieng, D. C. (2009). The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid, 19(11), 1215-1223.
- Her‐Juing Wu, H., Rose, C., & Elsheikh, T. M. (2012). 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. Diagnostic cytopathology, 40(5), 399-403.
- V. L. Ramesh, R. Ramu, C. Narayana Murthy. ”Accuracy of Fine Needle Aspiration Cytology of Thyroid Swellings”. Journal of Evidence based Medicine and Healthcare; Volume 1, Issue 16, December 22, 2014; Page: 2074-2078.
- Jo, V, Stelow E., Dustin S. ve ark. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for reporting thyroid cytopathology. American Journal of Clinical Pathology, 2010. 134(3): p. 450-456.
- Yassa L.,Cibas E. S., Benson C. B. ve ark. Long‐term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer Cytopathology, 2007. 111(6): p. 508-516.
- Muratli, A., Erdogan, N., Sevim, S., Unal, I., & Akyuz, S. (2014). Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. Journal of Cytology, 31(2), 73.
- Bagga, P. K., & Mahajan, N. C. (2010). Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it?. Indian journal of cancer, 47(4), 437.
- Pandey, P., Dixit, A., & Mahajan, N. C. (2012). Fine-needle aspiration of the thyroid: A cytohistologic correlation with critical evaluation of discordant cases. Thyroid Research and practice, 9(2), 32.
- Amrikachi M, Ramzy I, Rubenfeld S, et al. Accuracy of fineneedle aspiration of thyroid. Arch Pathol Lab Med 2001; 125: 484-8
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Patoloji |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2020 |
| Kabul Tarihi | 30 Haziran 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 45 Sayı: 3 |
