Zhu Yanli, Song Yuntao, Xu Guohui, Fan Zhihui, Ren Wenhao
Department of Head and Neck Surgery.
Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing 100142, China.
Chin J Cancer Res. 2020 Apr;32(2):140-148. doi: 10.21147/j.issn.1000-9604.2020.02.02.
To evaluate the diagnostic utility of The Bethesda System for Reporting Thyroid Cytology (TBSRTC) at Peking University Cancer Hospital, the incidence of noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), and the impact of reclassification on cytopathological outcomes.
We performed a retrospective study of thyroid fine-needle aspiration (FNA) cases between April 2014 and March 2019. The FNA results were classified according to TBSRTC. Post-surgery histological findings were followed up.
A total of 2,781 thyroid FNAs were performed. The incidences of the 6 diagnostic categories (DCs I-VI) were 14.8%, 17.1%, 15.8%, 2.3%, 11.6% and 38.5%, respectively. A total of 1,122 patients (40.3%) had corresponding histological results. NIFTP accounted for 0.4% of papillary thyroid carcinoma (PTC) cases, and there was no significant difference in the risk of malignancy (ROM) for each TBSRTC DC between "NIFTP=carcinoma (Ca)" and "NIFTP≠Ca". When "NIFTP=Ca", the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TBSRTC were 98.0%, 84.0%, 99.4%, 58.3%, and 97.5%, respectively. When "NIFTP≠Ca", the sensitivity, specificity, PPV, NPV and accuracy of the TBSRTC were 98.1%, 81.5%, 99.3%, 61.1%, and 97.5%, respectively.
TBSRTC is effective in the preoperative diagnosis of thyroid nodules in Peking University Cancer Hospital. The impact of the reclassification of NIFTP on cytopathological outcomes is limited because of its low incidence, and the revised ROMs are not suitable for Asian patients.
评估北京大学肿瘤医院甲状腺细胞病理学报告贝塞斯达系统（TBSRTC）的诊断效用、具有乳头样核特征的非侵袭性滤泡性甲状腺肿瘤（NIFTP）的发病率以及重新分类对细胞病理学结果的影响。
我们对2014年4月至2019年3月期间的甲状腺细针穿刺（FNA）病例进行了回顾性研究。FNA结果根据TBSRTC进行分类。对术后组织学结果进行随访。
共进行了2781例甲状腺FNA。6种诊断类别（DCs I-VI）的发生率分别为14.8%、17.1%、15.8%、2.3%、11.6%和38.5%。共有1122例患者（40.3%）有相应的组织学结果。NIFTP占甲状腺乳头状癌（PTC）病例的0.4%，“NIFTP=癌（Ca）”和“NIFTP≠Ca”之间各TBSRTC DC的恶性风险（ROM）无显著差异。当“NIFTP=Ca”时，TBSRTC的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为98.0%、84.0%、99.4%、58.3%和97.5%。当“NIFTP≠Ca”时，TBSRTC的敏感性、特异性、PPV、NPV和准确性分别为98.1%、81.5%、99.3%、61.1%和97.5%。
TBSRTC在北京大学肿瘤医院甲状腺结节的术前诊断中有效。由于NIFTP发病率低，其重新分类对细胞病理学结果的影响有限，且修订后的ROM不适用于亚洲患者。
