Malignancy Risk for Fine-Needle Aspiration of Thyroid Lesions According to The Bethesda System for Reporting Thyroid Cytopathology
Malignancy Risk for Fine-Needle Aspiration of Thyroid Lesions According to The Bethesda System for Reporting Thyroid Cytopathology
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DOI：
10.1309/ajcp5n4mthpafxfb
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发表时间：
2010-09-01
影响因子：
3.5
通讯作者：
Hanley, Krisztina Z.
中科院分区：
文献类型：
--
作者：
Jo, Vickie Y.;Stelow, Edward B.;Hanley, Krisztina Z.
细针穿刺（FNA）是甲状腺结节患者分诊的重要检查。2007年国家癌症研究所甲状腺细针抽吸科学状态会议帮助煽动最近出版的贝塞斯达系统报告甲状腺细胞病理学。我们回顾了3，080例甲状腺FNA样本，并根据建议的标准化6级命名法记录解释，并进行随访细胞学和组织学检查。在3，080例FNA中，18.6%为非诊断性，59.0%为良性，3.4%为意义不明的非典型滤泡性病变（AFLUS），9.7%为滤泡性肿瘤（SFN），2.3%为恶性肿瘤（SM），7.0%为恶性。在最初解释为非诊断性的574例病例中，47.9%仍为非诊断性。在892例中，有随访的组织学检查结果如下：恶性肿瘤8.9%，良性1.1%，AFLUS 17%（9/53），SFN 25.4%，SM 70%（39/56），恶性98.1%。因此，根据贝塞斯达系统，夏洛茨维尔弗吉尼亚大学卫生系统对甲状腺FNA样本的分类产生了与其他人报告的恶性肿瘤风险相似的结果。新的标准化命名法的普遍应用可能会改善实验室间的一致性，并导致更一致的管理方法。
Fine-needle aspiration (FNA) is an important test for triaging patients with thyroid nodules. The 2007 National Cancer Institute Thyroid Fine-Needle Aspiration State-of-the-Science Conference helped instigate the recent publication of The Bethesda System for Reporting Thyroid Cytopathology. We reviewed 3,080 thyroid FNA samples and recorded interpretations according to the proposed standardized 6-tier nomenclature, and pursued follow-up cytology and histology. Of the 3,080 FNAs, 18.6% were nondiagnostic, 59.0% were benign, 3.4% were atypical follicular lesion of undetermined significance (AFLUS), 9.7% were "suspicious" for follicular neoplasm (SFN), 2.3% were suspicious for malignancy (SM), and 7.0% were malignant. Of 574 cases originally interpreted as nondiagnostic, 47.9% remained nondiagnostic. In 892 cases, there was follow-up histology Rates of malignancy were as follows: nondiagnostic, 8.9%; benign, 1.1%; AFLUS 17% (9/53); SFN, 25.4%; SM, 70% (39/56), and malignant, 98.1%. Thus, classification of thyroid FNA samples at the University of Virginia Health System, Charlottesville, according to The Bethesda System yields similar results for risk of malignancy as reported by others. Universal application of the new standardized nomenclature may improve interlaboratory agreement and lead to more consistent management approaches.