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用于甲状腺结节评估的贝塞斯达系统:综述

Bethesda System in the evaluation of thyroid nodules: Review.

作者信息

Wesoła Marta, Jeleń Michał

机构信息

Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Poland.

出版信息

Adv Clin Exp Med. 2017 Jan-Feb;26(1):177-182. doi: 10.17219/acem/27319.

DOI:10.17219/acem/27319
PMID:28397450
Abstract

Fine needle aspiration (FNA) biopsy is an important and widely accepted method used in the diagnosis of patients with thyroid nodules.The lack of consistency in reporting FNA taken from the thyroid gland has led to divergences in the calculation of the sensitivity and specificity of the method. Discrepancies depend on what was considered to be true or false negative/positive. This resulted in confusion among doctors, who had to decide how to manage the patient with constantly changing positive or negative results of the FNA. The problem was solved in 2007, when "The Bethesda System for Reporting Thyroid Cytopathology" (TBSRTC) was introduced. Generally, TBSRTC, compared to previous systems, results in reducing the number of non-diagnostic/indeterminate cases and enables a better clinical usefulness of the results of the FNA of the thyroid gland. This is probably due to the introduction of more standard criteria for interpreting and reporting. TBSRTC improves communication between cytopathologists, reduces the number of unnecessary operations on benign lesions, and makes it possible to perform the operation on time in patients with malignant lesions and predict the risk of thyroid cancer. It provides a simple and reliable exchange of data not only between various laboratories but also between institutions throughout the world. Research shows that all indicators of malignancy calculated for all categories have similar value to the recommended rate of malignancy.

摘要

细针穿刺抽吸(FNA)活检是诊断甲状腺结节患者的一种重要且被广泛接受的方法。甲状腺FNA报告缺乏一致性,导致该方法敏感性和特异性计算存在差异。差异取决于对真阴性/阳性或假阴性/阳性的认定。这导致医生之间产生困惑,他们必须决定如何处理FNA结果不断变化为阳性或阴性的患者。2007年引入“甲状腺细胞病理学报告贝塞斯达系统”(TBSRTC)后,这个问题得到了解决。一般来说,与以前的系统相比,TBSRTC减少了非诊断性/不确定病例的数量,并使甲状腺FNA结果具有更好的临床实用性。这可能是由于引入了更标准的解读和报告标准。TBSRTC改善了细胞病理学家之间的沟通,减少了对良性病变进行不必要手术的数量,并使恶性病变患者能够及时进行手术,并预测甲状腺癌风险。它不仅在各个实验室之间,而且在全世界的机构之间提供了简单可靠的数据交换。研究表明,为所有类别计算的所有恶性指标与推荐的恶性率具有相似的值。

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