Mondal Santosh Kumar, Sinha Simanti, Basak Bijan, Roy Dipanwita Nag, Sinha Swapan Kumar
Department of Pathology, Medical College, Kolkata, West Bengal, India.
J Cytol. 2013 Apr;30(2):94-9. doi: 10.4103/0970-9371.112650.
The Bethesda system for reporting thyroid cytopathology represents a major step towards standardization, reproducibility, improved clinical significance, and greater predictive value of thyroid fine needle aspirates (FNAs).
To elucidate the utility of the Bethesda system in reporting thyroid FNAs.
We retrospectively reviewed thyroid FNAs between April 2009 and March 2012, classified them using the Bethesda system, found out the distribution of cases in each Bethesda category, and calculated the malignancy risk for each category by follow-up histopathology.
Of the 1020 FNAs, 1.2% were non-diagnostic, 87.5% were benign, 1% were atypical follicular lesion of undetermined significance (AFLUS), 4.2% were suspicious for follicular neoplasm (SFN), 1.4% were suspicious for malignancy (SM), and 4.7% malignant. Of 69 cases originally interpreted as non-diagnostic, 12 remained non-diagnostic after re-aspiration. In 323 cases, data of follow-up histopathologic examination (HPE) were available. Rates of malignancy reported on follow-up HPE were non-diagnostic 0%, benign 4.5%, AFLUS 20%, SFN 30.6%, SM 75%, and malignant 97.8%.
Reviewing the thyroid FNAs with the Bethesda system allowed a more specific cytological diagnosis. In this study, the distribution of cases in the Bethesda categories differed from some studies, with the number of benign cases being higher and the number of non-diagnostic and AFLUS cases being lower. The malignancy risk for each category correlated well with other studies. The Bethesda system thus allows standardization in reporting, improves perceptions of diagnostic terminology between cytopathologists and clinicians, and leads to more consistent management approaches.
甲状腺细胞病理学报告的贝塞斯达系统是朝着甲状腺细针穿刺抽吸活检（FNA）的标准化、可重复性、临床意义改善以及预测价值提高迈出的重要一步。
阐明贝塞斯达系统在报告甲状腺FNA中的实用性。
我们回顾性分析了2009年4月至2012年3月期间的甲状腺FNA，使用贝塞斯达系统对其进行分类，找出每个贝塞斯达类别中的病例分布，并通过后续组织病理学计算每个类别的恶性风险。
在1020例FNA中，1.2%为无法诊断，87.5%为良性，1%为意义不明确的非典型滤泡性病变（AFLUS），4.2%为滤泡性肿瘤可疑（SFN），1.4%为恶性可疑（SM），4.7%为恶性。在最初解释为无法诊断的69例病例中，再次穿刺后仍有12例无法诊断。在323例病例中，有后续组织病理学检查（HPE）的数据。后续HPE报告的恶性率为无法诊断0%，良性4.5%，AFLUS 20%，SFN 30.6%，SM 75%，恶性97.8%。
使用贝塞斯达系统对甲状腺FNA进行回顾可实现更具体的细胞学诊断。在本研究中，贝塞斯达类别中的病例分布与一些研究不同，良性病例数量较多，无法诊断和AFLUS病例数量较少。每个类别的恶性风险与其他研究相关性良好。因此，贝塞斯达系统允许报告标准化，改善细胞病理学家和临床医生之间对诊断术语的理解，并导致更一致的管理方法。
