Ucak Ramazan, Eryilmaz Ozlem Ton, Ozguven Banu Yılmaz, Uludag Mehmet, Kabukcuoğlu Fevziye
Department of Medical Pathology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul Turkey.
Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):93-100. doi: 10.14744/SEMB.2020.94752. eCollection 2021.
In this study, we aim to compare the results of aspiration of thyroid nodules evaluated according to the Bethesda category (BC) with tissue diagnoses in the operation materials and to compare the sensitivity, specificity and accuracy rates according to cytology methods.
The previous fine-needle aspiration biopsy (FNAB) of thyroid nodules of 879 cases diagnosed histopathologically between 2010 and 2017 was examined. The FNAB results determined according to the Bethesda system were matched with tissue diagnoses, sensitivity, specificity, and accuracy rates were investigated according to cytology methods.
Sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and accuracy rates were found in all FNAB results (in units of %; Sensitivity; 84.7, Specificity; 81.1, PPV; 74.1, NPV; 89.2, Accuracy; 82.5). All of the cytological evaluation methods of thyroid FNABs were found to be reliable and effective (Generally, the results are 80% and above). Specificity and accuracy rates were close to the general average (82.5%) in all methods. However, in cases evaluated with liquid base cytology (LBC) method and in addition to LBC or conventional smear (CS), the sensitivity rates in cases where cell block (CB) were evaluated together were higher than cases in which LBC and CS were used alone (92.6% and 91.0%). When examined statistically, there was no significant difference concerning sensitivity, specificity and accuracy rates of cytological methods (p>0.05, respectively, p=0.576, 0.065, 0.643).
In cytopathology, when evaluating thyroid aspirations, it is seen that the LBC method is used instead of CS. In our study, we recommend the use of the LBC method, which seems to have the highest sensitivity (taking into account its technical advantages), instead of CS. However, we think that both CS and LBC methods should be evaluated by supporting them with cell block sections.
在本研究中，我们旨在比较根据贝塞斯达分类（BC）评估的甲状腺结节细针穿刺抽吸结果与手术材料中的组织诊断结果，并根据细胞学方法比较敏感性、特异性和准确率。
检查了2010年至2017年间经组织病理学诊断的879例甲状腺结节的既往细针穿刺活检（FNAB）。将根据贝塞斯达系统确定的FNAB结果与组织诊断进行匹配，根据细胞学方法研究敏感性、特异性和准确率。
在所有FNAB结果中发现了敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确率（以%为单位；敏感性：84.7，特异性：81.1，PPV：74.1，NPV：89.2，准确率：82.5）。发现所有甲状腺FNAB的细胞学评估方法都是可靠且有效的（一般来说，结果在80%及以上）。所有方法的特异性和准确率接近总体平均值（82.5%）。然而，在用液基细胞学（LBC）方法评估的病例中，以及除LBC或传统涂片（CS）外，同时评估细胞块（CB）的病例的敏感性率高于单独使用LBC和CS的病例（分别为92.6%和91.0%）。经统计学检查，细胞学方法的敏感性、特异性和准确率无显著差异（p分别>0.05，p = 0.576、0.065、0.643）。
在细胞病理学中，在评估甲状腺穿刺抽吸时，可以看到使用LBC方法代替CS。在我们的研究中，我们建议使用似乎具有最高敏感性的LBC方法（考虑到其技术优势），而不是CS。然而，我们认为CS和LBC方法都应通过细胞块切片进行支持评估。
