Department of Otolaryngology, Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
Otolaryngology - Head and Neck Surgery Unit, The Hillel Yaffe Medical Center, Hadera, Israel; Faculty of Medicine, Technion, Haifa, Israel.
Eur J Surg Oncol. 2021 Jun;47(6):1370-1375. doi: 10.1016/j.ejso.2021.03.237. Epub 2021 Mar 15.
The Bethesda System for Reporting Thyroid Cytopathology was developed in 2007 to facilitate an accurate, reproducible communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists and to serve as a guide for treatment. Based on large patient series, the system details the risk of malignancy for each category as well as a suggested management for each FNA result. Though this system has been widely adopted, there are only few studies to determine whether results are applicable for Israel.
A multicenter, retrospective analysis of medical charts of all patients who underwent thyroid surgery between January 1st, 2012 and December 31st, 2016 in four medical centers in Israel was performed. Data was analyzed for the overall risk of malignancy for the Bethesda system groups as well as comparison between the different laboratories performing the test.
Records of 810 thyroidectomies in which preoperative cytological reports and final pathology were available and reviewed. The malignancy rates according to the Bethesda groups' I-VI for our cohort were: 27.8%, 17.6%, 41.4%, 41.4%, 86.9%, and 98.1% respectively. Similar results were seen when results were analyzed according to the different laboratories performing the tests.
Post-surgical review of all Bethesda groups had higher malignancy rates than those reported in the original report. These results indicate a difference in the malignancy rates for the different Bethesda system groups in Israel compared to those reported. Physicians are encouraged to use data validated for their own country or patients' community in addition to published values.
贝塞斯达系统（Bethesda System）于 2007 年开发，用于促进临床医生和细胞病理学家之间准确、可重复地交流甲状腺细针抽吸（FNA）结果，并为治疗提供指导。该系统基于大量患者系列，详细说明了每个类别恶性肿瘤的风险，以及每个 FNA 结果的建议管理方案。尽管该系统已被广泛采用，但只有少数研究确定其结果是否适用于以色列。
对以色列四个医疗中心于 2012 年 1 月 1 日至 2016 年 12 月 31 日期间接受甲状腺手术的所有患者的病历进行了多中心、回顾性分析。分析了贝塞斯达系统各分组的总体恶性肿瘤风险，以及不同实验室进行检测的结果比较。
对 810 例甲状腺切除术患者的术前细胞学报告和最终病理记录进行了评估和审查。根据贝塞斯达系统的 I-VI 分组，我们队列的恶性肿瘤发生率分别为：27.8%、17.6%、41.4%、41.4%、86.9%和 98.1%。根据不同实验室进行检测的结果进行分析，也得到了类似的结果。
对所有贝塞斯达系统分组的术后回顾显示，恶性肿瘤发生率高于原始报告中的报道。这些结果表明，与报道的结果相比，以色列不同贝塞斯达系统分组的恶性肿瘤发生率存在差异。鼓励医生在使用公布的数值的同时，使用针对自己国家或患者群体的数据。
