Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India.
Department of Radiology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India.
Cytopathology. 2023 Nov;34(6):590-596. doi: 10.1111/cyt.13273. Epub 2023 Jul 20.
The age-standardised incidence rate of thyroid cancer in India is 1 in 416 in the general population. This increased incidence has mainly been attributed to improved detection methods for small thyroid lesions. Two such methods are the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
To study the correlation between ACR TIRADS and TBSRTC, and between each system and the final histopathological report.
Thyroid cytopathology cases were retrieved for the period January 2019 to July 2022. For each case, the TIRADS score and Bethesda category were noted. Histopathology specimens were also traced.
The study comprised 1100 cases, with 955 female and 145 male patients (M:F = 1:6.59), and ages ranging between 7 and 85 years. The TIRADS scoring was available for 1036 cases. Histopathology was available for 231 cases. There was a significant correlation between TIRADS and TBSRTC, with a p-value of 0.000 and a substantial Kappa agreement of 0.688. Both TIRADS and TBSRTC also had significant correlations with the histopathology data, with a p-value of 0.000 for each. The sensitivity values for TBSRTC and TIRADS were 69.4% and 65.8%; specificity, 99.3% and 96.5%; positive predictive value (PPV), 98.3% and 91.8%; and negative predictive value (NPV) 84.7% and 84.4%, respectively. The risk of malignancy (ROM) was also calculated and was found to be high, especially for TBSRTC II, III, IV and V (11.3%, 20%, 61.5%, 97.4% respectively) and TIRADS 2 and 3 (10.3% and 29.6% respectively).
The TIRADS and TBSRTC systems of categorisation of thyroid lesions are concordant and could help improve the overall survival rate of patients with thyroid malignancies.
在印度，甲状腺癌的年龄标准化发病率在普通人群中为每 416 人中有 1 人。这种发病率的增加主要归因于对甲状腺小病变的检测方法的改进。两种这样的方法是美国放射学院甲状腺成像报告和数据系统（ACR TIRADS）和甲状腺细胞学报告贝塞斯达系统（TBSRTC）。
研究 ACR TIRADS 与 TBSRTC 之间的相关性，以及每个系统与最终组织病理学报告之间的相关性。
回顾 2019 年 1 月至 2022 年 7 月期间的甲状腺细胞学病例。对于每个病例，记录 TIRADS 评分和贝塞斯达类别。还追踪了组织病理学标本。
本研究包括 1100 例病例，其中 955 例为女性，145 例为男性（M：F=1：6.59），年龄在 7 至 85 岁之间。1036 例病例有 TIRADS 评分。231 例有组织病理学资料。TIRADS 和 TBSRTC 之间存在显著相关性，p 值为 0.000，kappa 一致性为 0.688。TIRADS 和 TBSRTC 与组织病理学数据也存在显著相关性，p 值均为 0.000。TBSRTC 和 TIRADS 的灵敏度值分别为 69.4%和 65.8%；特异性为 99.3%和 96.5%；阳性预测值（PPV）分别为 98.3%和 91.8%；阴性预测值（NPV）分别为 84.7%和 84.4%。恶性风险（ROM）也进行了计算，发现 TBSRTC II、III、IV 和 V 以及 TIRADS 2 和 3 的 ROM 很高，分别为 11.3%、20%、61.5%、97.4%和 10.3%、29.6%。
甲状腺病变分类的 TIRADS 和 TBSRTC 系统是一致的，可以帮助提高甲状腺恶性肿瘤患者的总体生存率。
