Wu Maoxin, Choi YoonSun, Zhang Zesong, Si Quisheng, Salem Fadi, Szporn Arnold, Zhang David, Burstein David, Teng Marita, Miles Brett A, Genden Eric
Department of Pathology, Stony Brook Medicine, Stony Brook University, New York, New York.
Department of Pathology, The Icahn School of Medicine at Mount Sinai, New York, New York.
Diagn Cytopathol. 2016 Oct;44(10):787-91. doi: 10.1002/dc.23544. Epub 2016 Jul 26.
Ultrasound (US) guided fine needle aspiration (FNA) biopsy of thyroid are examined and reported by cytopathologists based usually on The Bethesda System for Reporting Thyroid Cytopathology (BTC) regardless of the procedure's performers. This study is designed to determine whether there is any performer-dependent difference.
Six hundred and fifty-one thyroid US-FNAs in correlation with surgical follow-up (SFU) were studied. The statistical analysis was performed using the surgical pathology diagnosis as the gold standard.
Among the 283 cases performed by cytopathologists, there were 8 (2.8%) nondiagnostic (BTC I), 197 (69.6%) benign (BTC II), 31 (11%) atypical (BTC III), 14 (5%) suspicious for follicular neoplasm (BTC IV), 12 (4.2%) suspicious for malignancy (BTC V), and 21 (7.4%) positive for malignancy (BTC VI), and there were 55 (19.4%) cases with SFU. The 368 cases performed by others showed 76 (21%) BTC I, 238 (65%) BTC II, 26 (7%) BTC III, 10 (3%) BTC IV, 9 (2.5%) BTC V 5, and 9 (2.5%) BTC VI, and there were 26 (7%) cases with SFU. The cytopathologist group achieved better sensitivity (91.3 vs.78%); slightly better specificity (83.3 vs. 82%); better positive predictive value (87.5 vs. 70%); similar negative predictive value (88.2 vs. 88%); and better overall accuracy (87.8 vs. 81%) compared with the non-cytopathologist group. Overall the difference for all statistical values is significant different (P = 0.041).
US-FNA performed by cytopathologists showed a lower unsatisfactory rate and significantly better overall statistical values. Cytopathologists may play an important role in thyroid patient care. Diagn. Cytopathol. 2016;44:787-791. © 2016 Wiley Periodicals, Inc.
甲状腺超声（US）引导下细针穿刺抽吸（FNA）活检通常由细胞病理学家根据《甲状腺细胞病理学报告贝塞斯达系统》（BTC）进行检查和报告，而不考虑操作执行者。本研究旨在确定是否存在与执行者相关的差异。
对651例与手术随访（SFU）相关的甲状腺US-FNA进行了研究。以手术病理诊断作为金标准进行统计分析。
在细胞病理学家操作的283例病例中，有8例（2.8%）诊断不明确（BTC I），197例（69.6%）为良性（BTC II），31例（11%）为非典型性（BTC III），14例（5%）疑为滤泡性肿瘤（BTC IV），12例（4.2%）疑为恶性（BTC V），21例（7.4%）为恶性阳性（BTC VI），有55例（19.4%）进行了SFU。其他人员操作的368例病例显示，76例（21%）为BTC I，238例（65%）为BTC II，26例（7%）为BTC III，10例（3%）为BTC IV，9例（2.5%）为BTC V，5例，9例（2.5%）为BTC VI，有26例（7%）进行了SFU。与非细胞病理学家组相比，细胞病理学家组具有更高的敏感性（91.3%对78%）；略高的特异性（83.3%对82%）；更高的阳性预测值（87.5%对70%）；相似的阴性预测值（88.2%对88%）；以及更高的总体准确率（87.8%对81%）。总体而言，所有统计值的差异具有显著性（P = 0.041）。
细胞病理学家进行的US-FNA显示出较低的不满意率和显著更好的总体统计值。细胞病理学家可能在甲状腺患者护理中发挥重要作用。诊断细胞病理学。2016；44：787 - 791。©2016威利期刊公司。
