Truong Phan Xuan Nguyen1, Vien Thanh Truong2, Kennichi Kakudo3, Huy Gia Vuong4,5. 1. Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, Vietnam. 2. Department of Cardiology, The Christ Hospital Health Network, Cincinnati, OH, USA. 3. Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi-city, Japan. 4. Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA. 5. Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.
Abstract
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been adopted and widely used among Asian countries. This study aims to investigate the application of TBSRTC in thyroid cytology practice among Asian countries. METHODS: We searched electronic databases including PubMed and Web of Science from 2010 to 2019. Meta-analysis of proportion and their 95% confidence intervals (CIs) were calculated using the random-effect model. Meta-regression and subgroup analysis were used to search for heterogeneity origins. RESULTS: We included 42 Asian studies with 84.953 fine-needle aspirations. Among six categories, benign was the most commonly diagnosed category. The resection rate (RR) and risk of malignancy (ROM) were highest in malignant and SM categories, and lowest among benign nodules. Thyroid cytology practice in Asia was characterized by a low RR and high ROM in patients with indeterminate thyroid nodules. There was a significant amount of heterogeneities of TBSRTC outputs (frequency, resection rate, and malignancy risk) among Asian countries. Meta-regression showed that the sources of heterogeneity might stem from the differences in study origin and the application of molecular testing. We highlighted the usefulness of preoperative molecular testing to select patients for surgery. CONCLUSIONS: Our study provided insight regarding thyroid cytology practice among Asian countries. Active surveillance is commonly used in Asian practice resulting in a low RR and high ROM for indeterminate nodules. There are still variations in general thyroid cytology practice in Asia. Future guidelines and consensus regarding the application of TBSRTC in thyroid cytology practice among Asian countries are required. 2020 Gland Surgery. All rights reserved.
BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been adopted and widely used among Asian countries. This study aims to investigate the application of TBSRTC in thyroid cytology practice among Asian countries. METHODS: We searched electronic databases including PubMed and Web of Science from 2010 to 2019. Meta-analysis of proportion and their 95% confidence intervals (CIs) were calculated using the random-effect model. Meta-regression and subgroup analysis were used to search for heterogeneity origins. RESULTS: We included 42 Asian studies with 84.953 fine-needle aspirations. Among six categories, benign was the most commonly diagnosed category. The resection rate (RR) and risk of malignancy (ROM) were highest in malignant and SM categories, and lowest among benign nodules. Thyroid cytology practice in Asia was characterized by a low RR and high ROM in patients with indeterminate thyroid nodules. There was a significant amount of heterogeneities of TBSRTC outputs (frequency, resection rate, and malignancy risk) among Asian countries. Meta-regression showed that the sources of heterogeneity might stem from the differences in study origin and the application of molecular testing. We highlighted the usefulness of preoperative molecular testing to select patients for surgery. CONCLUSIONS: Our study provided insight regarding thyroid cytology practice among Asian countries. Active surveillance is commonly used in Asian practice resulting in a low RR and high ROM for indeterminate nodules. There are still variations in general thyroid cytology practice in Asia. Future guidelines and consensus regarding the application of TBSRTC in thyroid cytology practice among Asian countries are required. 2020 Gland Surgery. All rights reserved.
Entities:
Keywords:
Asia; The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC); cytology; fine-needle aspiration (FNA); resection rate; risk of malignancy (ROM); thyroid
Authors: Mousa A Al-Abbadi; Sameera Q Shareef; Mohammad M Yousef; Nidal M Almasri; Huda E Mustafa; Hameed Aljawad; Jassim A Ali; Alan Groves; Yasmen Alsaihati Journal: Diagn Cytopathol Date: 2017-09-01 Impact factor: 1.582