Na Hee Young, Higuchi Miyoko, Satoh Shinya, Kameyama Kaori, Jung Chan Kwon, Shin Su-Jin, Agarwal Shipra, Hang Jen-Fan, Zhu Yun, Liu Zhiyan, Bychkov Andrey, Kakudo Kennichi, Park So Yeon
Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan.
J Pathol Transl Med. 2024 Nov;58(6):331-340. doi: 10.4132/jptm.2024.10.12. Epub 2024 Nov 7.
This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs).
Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs.
The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs.
Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.
本研究旨在比较多机构亚洲系列甲状腺细针穿刺细胞学检查（FNAC）的诊断类别及甲状腺肿瘤的发病率，特别关注诊断类别IV（可疑滤泡性肿瘤）和滤泡状甲状腺癌（FTC）。
收集了来自亚洲五个国家10个机构的FNAC类别分布、切除标本中甲状腺肿瘤的发病率以及手术确诊的滤泡性腺瘤（FA）和FTC的细胞学诊断结果，并在不同国家之间以及FA和FTC之间进行比较。
术前FNAC中IV类诊断的频率（3.0%）显著低于西方国家（10.1%）。在比较亚洲国家的诊断类别时，IV类在日本（4.6%）和印度（7.9%）比在台湾（1.4%）、韩国（1.4%）和中国（3.6%）更常见。同样，手术切除标本中FA和FTC的发病率在日本（10.9%）和印度（10.1%）显著高于台湾（5.5%）、韩国（3.0%）和中国（2.5%）。与韩国（33.3%）和中国（35.0%）相比，日本（77.5%）的FTC更常被诊断为IV类。与FA相比，核多形性、核拥挤、微滤泡模式和细胞解离模式在FTC中更常见。
我们的研究强调了亚洲国家FTC的FNAC诊断类别存在差异，这可能与不同的报告系统和甲状腺癌发病率有关。发现核多形性、核拥挤、微滤泡模式和细胞解离模式等细胞学特征有助于更有效地诊断FTC。
