Alabdulqader Noof A, Shareef Sameera Q, Ali Jassim A, Yousef Mohammad M, Al-Abbadi Mousa A
Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia.
Acta Cytol. 2015;59(3):233-8. doi: 10.1159/000430803. Epub 2015 May 30.
This is a follow-up study to our previous analysis of thyroid aspirates utilizing the Bethesda System for Reporting Thyroid Cytology (BSRTC). The same study design was utilized for 2 years comparing 2 periods. A total of 251 thyroid aspirates from 218 patients were reviewed and deemed comparable to the previous cohort. The variance and consequently the number of interpretations dropped from 26 to 11 with a statistically significant 58% reduction and more consistency. Our unsatisfactory rate dropped from 22 to 10% (reduction of 55%). The risk of malignancy in this follow-up study showed a similar trend: an increase in risk with each step up in the BSRTC categories starting from the 'nondiagnostic' and up to 'malignant'. Few of our benign cases ended up with resection. We noticed sensitivity to the word 'follicular' in this benign category; therefore we propose a modification of the current BSRTC system by omitting the word 'follicular' from the benign category. We strongly believe that this modification harbors no serious damage to the intentions of BSRTC. This follow-up study has shown that the previous awareness campaign about the implementation has worked and can be considered a valid performance improvement program.
这是我们之前利用甲状腺细胞病理学报告贝塞斯达系统（BSRTC）对甲状腺细针穿刺抽吸物进行分析的一项随访研究。采用相同的研究设计，对两个时间段进行了为期2年的比较。对来自218例患者的251份甲状腺细针穿刺抽吸物进行了复查，认为与之前的队列具有可比性。变异度以及因此产生的解读数量从26降至11，统计学上有显著的58%的降幅，且一致性更高。我们的不满意率从22%降至10%（降低了55%）。在这项随访研究中，恶性风险呈现出类似的趋势：从BSRTC分类中的“无法诊断”到“恶性”，随着分类等级的升高，风险增加。我们的良性病例中很少最终进行了切除手术。我们注意到在这个良性类别中对“滤泡性”一词较为敏感；因此，我们提议对当前的BSRTC系统进行修改，从良性类别中省略“滤泡性”一词。我们坚信这种修改不会对BSRTC的意图造成严重损害。这项随访研究表明，之前关于该实施的宣传活动已经起作用，可以被视为一个有效的绩效改进项目。
