Al-Maghrabi Hatim, Tashkandi Mohamed, Khayyat Waleed, Alghamdi Amer, Alsalmi Mohammed, Alzahrani Alhussain, Al-Hakami Hadi, Alqarni Mohammed
Department of Pathology and Laboratory Medicine, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Saudi J Med Med Sci. 2022 May-Aug;10(2):105-110. doi: 10.4103/sjmms.sjmms_202_21. Epub 2022 Apr 21.
The introduction of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has been shown to decrease the risk of malignancy (ROM) in The Bethesda System for Reporting Thyroid Cytopathology. This knowledge may alter the management of patients with thyroid nodules.
To correlate cytological diagnosis with histological diagnosis for establishing the ROM of all Bethesda system categories after the introduction of NIFTP.
This was a retrospective cohort study. All consecutive fine-needle aspiration cytology (FNAC) specimens collected from January 1, 2013, to December 31, 2017, at King Abdullah Medical City, Jeddah, Saudi Arabia, were assessed, and patients who underwent surgical excision of thyroid nodules were further analyzed. The ROM and overall ROM for each Bethesda category were calculated with and without considering NIFTP as a malignant tumor.
Overall, 1066 FNAC specimens were collected, of which 281 had a surgical correlation. Our cases included 18 (6.4%) non-diagnostic (ND), 109 (38.8%) benign, 28 (9.9%) atypia/follicular lesion of undetermined significance (AUS/FLUS), 39 (13.8%) follicular neoplasm or suspicion for follicular neoplasm (FN/SFN), 20 (7.1%) suspicion for malignancy (SM), and 67 (23.8%) malignant (POM) cases. After considering NIFTP diagnosis on resection specimens, the ROM decreased as follows: ND, 38.8% to 27.7% ( = 0.2388); benign, 21.1% to 11.9% ( = 0.0343); AUS/FLUS, 50% to 39.2% ( = 0.2089); FN/SFN, 53.8% to 33.3% ( = 0.0336); SM, 85% to 75% ( = 0.2147); POM, 95.5% to 88% ( = 0.0582).
The introduction of NIFTP would significantly decrease the ROM of thyroid FNAC in both benign and FN/SFN categories of the Bethesda system.
具有乳头样核特征的非侵袭性滤泡性甲状腺肿瘤（NIFTP）的引入已显示可降低《甲状腺细胞病理学报告贝塞斯达系统》中的恶性风险（ROM）。这一认识可能会改变甲状腺结节患者的管理方式。
在引入NIFTP后，将细胞学诊断与组织学诊断相关联，以确定所有贝塞斯达系统分类的ROM。
这是一项回顾性队列研究。对2013年1月1日至2017年12月31日在沙特阿拉伯吉达阿卜杜拉国王医疗城收集的所有连续细针穿刺抽吸细胞学（FNAC）标本进行评估，并对接受甲状腺结节手术切除的患者进行进一步分析。在将NIFTP视为恶性肿瘤和不视为恶性肿瘤的情况下，分别计算每个贝塞斯达分类的ROM和总体ROM。
总体而言，共收集了1066份FNAC标本，其中281份有手术相关性。我们的病例包括18例（6.4%）无法诊断（ND）、109例（38.8%）良性、28例（9.9%）意义不明确的非典型性/滤泡性病变（AUS/FLUS）、39例（13.8%）滤泡性肿瘤或疑似滤泡性肿瘤（FN/SFN）、20例（7.1%）疑似恶性（SM）以及67例（23.8%）恶性（POM）病例。在考虑切除标本上的NIFTP诊断后，ROM降低如下：ND，从38.8%降至27.7%（P = 0.2388）；良性，从21.1%降至11.9%（P = 0.0343）；AUS/FLUS，从50%降至39.2%（P = 0.2089）；FN/SFN，从53.8%降至33.3%（P = 0.0336）；SM，从85%降至75%（P = 0.2147）；POM，从95.5%降至88%（P = 0.0582）。
NIFTP的引入将显著降低贝塞斯达系统中良性和FN/SFN类别的甲状腺FNAC的ROM。
