Tartaglia F, Giuliani A, Tromba L, Carbotta S, Karpathiotakis M, Tortorelli G, Pelle F, Merola R, Donello C, Carbotta G, De Anna L, Conzo G, Sorrenti S, Ulisse S
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.
J Biol Regul Homeost Agents. 2016 Oct-Dec;30(4):1187-1193.
The new Italian cytological classification (SIAPEC 2014) of thyroid nodules, in line with those of Bethesda and BTA-RCPath, replaces the previous TIR3 class with two new classes (TIR3A and TIR3B), which correspond to different risks of malignancy and clinical actions required. The present study was conducted to evaluate the diagnostic accuracy of the new SIAPEC classification as opposed to its previous version (SIAPEC 2007). Preoperative cytology was compared with the final histology obtained from 650 consecutive patients who underwent total thyroidectomy for multinodular goiter. Of this total, 434 patients (group A) had their cytological diagnosis based on the old SIAPEC 2007 classification and 216 patients (group B) had their cytological diagnosis based on the SIAPEC 2014 classification. In group A 111 patients (25.6%) had a TIR3 diagnosis, while in group B 52 patients (24.1%) received a TIR3 diagnosis, of whom 30 had TIR3A and 22 had TIR3B. In group A, 46 (41.4%) out of the 111 patients with TIR3 diagnosis had, based on histology, a thyroid carcinoma. In group B, only 2 (6.7%) out of 30 patients with TIR3A diagnosis had a thyroid carcinoma. This rate of malignancy was significantly lower (p less than 0.001) than that observed in patients with TIR3B diagnosis, in which 12 (54.5%) out of 22 patients had a carcinoma. The observations here reported show that, in respect to the previous version, the new Italian cytological classification provides greater diagnostic accuracy for detecting thyroid nodule malignancy.
意大利新的甲状腺结节细胞学分类（SIAPEC 2014）与贝塞斯达分类和英国皇家病理学会（BTA-RCPath）分类一致，用两个新类别（TIR3A和TIR3B）取代了之前的TIR3类别，这两个新类别对应不同的恶性风险和所需的临床行动。本研究旨在评估新的SIAPEC分类相对于其先前版本（SIAPEC 2007）的诊断准确性。将术前细胞学检查结果与650例因多结节性甲状腺肿接受全甲状腺切除术的连续患者的最终组织学检查结果进行比较。其中，434例患者（A组）的细胞学诊断基于旧的SIAPEC 2007分类，216例患者（B组）的细胞学诊断基于SIAPEC 2014分类。A组有111例患者（25.6%）诊断为TIR3，而B组有52例患者（24.1%）诊断为TIR3，其中30例为TIR3A，22例为TIR3B。A组中，111例TIR3诊断患者中有46例（41.4%）经组织学检查确诊为甲状腺癌。B组中，30例TIR3A诊断患者中只有2例（6.7%）患有甲状腺癌。该恶性率显著低于TIR3B诊断患者的恶性率（p小于0.001），TIR3B诊断患者中22例中有12例（54.5%）患有癌症。此处报告的观察结果表明，相对于先前版本，新的意大利细胞学分类在检测甲状腺结节恶性肿瘤方面具有更高的诊断准确性。
