You-Bin Lee1, Yoon Young Cho2, Ju Young Jang3, Tae Hyuk Kim1, Hye Won Jang4, Jae Hoon Chung1, Young Lyun Oh5, Sun Wook Kim1. 1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. 3. Division of Endocrinology and Metabolism, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. 4. Department of Medical Education, Sungkyunkwan University School of Medicine, Seoul, Korea. 5. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
BACKGROUND: Most studies validating the Bethesda system for reporting thyroid cytopathology (TBSRTC) have been conducted in Western countries. We explored the current status of TBSRTC in an area where most thyroid malignancies are papillary carcinomas. METHODS: Fine-needle aspirations (FNAs) of thyroid nodules performed in 2013 were retrospectively analyzed and the results were compared to final pathology on resection. RESULTS: Of 1947 FNAs, 1925 (98.9%) were reported using TBSRTC. Among 381 resected lesions, 27.3% of nondiagnostic, 19.6% of benign, 56.0% of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 33.3% of follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN), 97.7% of suspicious for malignancy, and 100.0% of malignant lesions were malignant on pathology. The sensitivity and specificity of FNA using TBSRTC were 96.7% and 84.1%, respectively. CONCLUSION: TBSRTC works well in an area in which papillary thyroid cancer is prevalent; however, it may underestimate malignancy rates in AUS/FLUS, benign, and nondiagnostic categories.
BACKGROUND: Most studies validating the Bethesda system for reporting thyroid cytopathology (TBSRTC) have been conducted in Western countries. We explored the current status of TBSRTC in an area where most thyroid malignancies are papillary carcinomas. METHODS: Fine-needle aspirations (FNAs) of thyroid nodules performed in 2013 were retrospectively analyzed and the results were compared to final pathology on resection. RESULTS: Of 1947 FNAs, 1925 (98.9%) were reported using TBSRTC. Among 381 resected lesions, 27.3% of nondiagnostic, 19.6% of benign, 56.0% of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 33.3% of follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN), 97.7% of suspicious for malignancy, and 100.0% of malignant lesions were malignant on pathology. The sensitivity and specificity of FNA using TBSRTC were 96.7% and 84.1%, respectively. CONCLUSION: TBSRTC works well in an area in which papillary thyroid cancer is prevalent; however, it may underestimate malignancy rates in AUS/FLUS, benign, and nondiagnostic categories.