Yazgan A, Balci S, Dincer N, Kiyak G, Tuzun D, Ersoy R, Cakir B, Guler G
Department of Pathology, Yildirim Beyazit University Ankara Ataturk Research and Training Hospital, Ankara, Turkey.
Cytopathology. 2014 Jun;25(3):185-9. doi: 10.1111/cyt.12093. Epub 2013 Sep 11.
We aimed to determine whether the presence of Hürthle cells altered the distribution of categories in the Bethesda system for reporting thyroid cytopathology, or the expected neoplastic and malignant outcome.
Fine needle aspiration (FNA) cytology reports of Hürthle cells in a 2-year period were evaluated. The distribution of Bethesda system categories and the outcome at partial or complete thyroidectomy were compared for FNAs with and without Hürthle cells.
Of 895 adequate FNAs with Hürthle cells, 764 (85.4%) were classified as benign, 86 (9.6%) as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 32 (3.6%) as follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 12 (1.3%) as suspicious for malignancy (SFM) and one (0.1%) as malignant. Of 10 359 adequate FNAs without Hürthle cells, 9707 (93.7%) were classified as benign, 412 (4.0%) as AUS/FLUS, 77 (0.7%) as FN/SFN, 93 (0.9%) as SFM and 70 (0.7%) as malignant. The distribution of categories in FNAs with and without Hürthle cells was significantly different (P < 0.001) as a result of a decrease in benign and an increase in AUS/FLUS and FN/SFN categories. Among 128 patients with and 582 without Hürthle cells undergoing surgery, the overall neoplastic and malignancy rates were higher in the former than in the latter group (27.3% versus 14.9%, P < 0.001; 21.1% versus 11.7%, P = 0.003; respectively). Although neoplastic and malignant rates were higher in the group with than without Hürthle cells in all categories, the differences were only significant for a neoplastic outcome of benign cytology (15.1% versus 6.0%, P = 0.0013) and a malignant outcome of FN/SFN cytology (63.6% versus 21.9%, P = 0.0108).
We found that the rates of AUS/FLUS and FN/SFN categories in the Bethesda system were higher when Hürthle cells were present. After surgery, neoplastic and malignant outcomes were significantly higher in the Hürthle cell group.
我们旨在确定许特莱细胞的存在是否会改变甲状腺细胞病理学报告的贝塞斯达系统中的分类分布，或预期的肿瘤性和恶性结果。
对两年内许特莱细胞的细针穿刺（FNA）细胞学报告进行评估。比较有和没有许特莱细胞的FNA在贝塞斯达系统分类中的分布情况以及部分或全甲状腺切除术后的结果。
在895份含有许特莱细胞的充分FNA中，764份（85.4%）被分类为良性，86份（9.6%）为意义不明确的非典型性/意义不明确的滤泡性病变（AUS/FLUS），32份（3.6%）为滤泡性肿瘤/可疑滤泡性肿瘤（FN/SFN），12份（1.3%）为可疑恶性（SFM），1份（0.1%）为恶性。在10359份不含有许特莱细胞的充分FNA中，9707份（93.7%）被分类为良性，412份（4.0%）为AUS/FLUS，77份（0.7%）为FN/SFN，93份（0.9%）为SFM，70份（0.7%）为恶性。由于良性分类减少以及AUS/FLUS和FN/SFN分类增加，含有和不含有许特莱细胞的FNA分类分布存在显著差异（P<0.001）。在128例有许特莱细胞和582例无许特莱细胞接受手术的患者中，前一组的总体肿瘤性和恶性率高于后一组（分别为27.3%对14.9%，P<0.001；21.1%对11.7%，P=0.003）。尽管在所有分类中，有许特莱细胞组的肿瘤性和恶性率均高于无许特莱细胞组，但差异仅在良性细胞学的肿瘤性结果（15.1%对6.0%，P=0.0013）和FN/SFN细胞学的恶性结果（63.6%对21.9%，P=0.0108）方面具有统计学意义。
我们发现，当存在许特莱细胞时，贝塞斯达系统中AUS/FLUS和FN/SFN分类的比例更高。手术后，许特莱细胞组的肿瘤性和恶性结果显著更高。
