Dept. of Pathology, Queen Alexandra Hospital, Cosham, Portsmouth, England.
Am J Clin Pathol. 2011 Jun;135(6):852-9. doi: 10.1309/AJCPZ33MVMGZKEWU.
The overall interobserver reproducibility of thyroid fine-needle aspiration (FNA) has not been comprehensively assessed. A blinded 6-rater interobserver reproducibility study was conducted of 200 thyroid FNA cases using the UK System, which is similar to The Bethesda System for Reporting Thyroid Cytology: Thy1, nondiagnostic; Thy2, nonneoplastic; Thy3a, atypia, probably benign; Thy3f, follicular lesion; Thy4, suspicious of malignancy; and Thy5, malignant. There was good interobserver agreement for the Thy1 (κ = 0.69) and Thy5 (κ = 0.61), moderate agreement for Thy2 (κ = 0.55) and Thy3f (κ = 0.51), and poor agreement for Thy3a (κ = 0.11) and Thy4 (κ = 0.17) categories. Combining categories implying surgical management (Thy3f, Thy4, and Thy5) achieved good agreement (κ = 0.72), as did combining categories implying medical management (Thy1, Thy2, and Thy3a; κ = 0.72). The UK thyroid FNA terminology is a reproducible and clinically relevant system for thyroid FNA reporting. This study demonstrates that international efforts to harmonize and refine thyroid cytology classification systems can improve consistency in the clinical management of thyroid nodules.
甲状腺细针抽吸（FNA）的整体观察者间可重复性尚未得到全面评估。使用类似于英国系统的报告甲状腺细胞学的 Bethesda 系统，对 200 例甲状腺 FNA 病例进行了 6 名观察者的盲法观察者间可重复性研究：Thy1，非诊断性；Thy2，非肿瘤性；Thy3a，不典型，可能良性；Thy3f，滤泡性病变；Thy4，疑似恶性；和 Thy5，恶性。Thy1（κ = 0.69）和 Thy5（κ = 0.61）的观察者间一致性良好，Thy2（κ = 0.55）和 Thy3f（κ = 0.51）的观察者间一致性中等，Thy3a（κ = 0.11）和 Thy4（κ = 0.17）的观察者间一致性较差。手术处理的类别（Thy3f、Thy4 和 Thy5）联合达成了良好的一致性（κ = 0.72），而暗示药物治疗的类别（Thy1、Thy2 和 Thy3a；κ = 0.72）也是如此。英国甲状腺 FNA 术语是一种可重复且与临床相关的甲状腺 FNA 报告系统。本研究表明，协调和完善甲状腺细胞学分类系统的国际努力可以提高甲状腺结节临床管理的一致性。
