Biswas Sushrita, Shah Ina, Goswami Hansa, Chaudhuri Avik
Department of Pathology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.
Department of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.
Indian J Pathol Microbiol. 2025 Mar 13. doi: 10.4103/ijpm.ijpm_165_24.
Recent advancements in diagnostic techniques have resulted in a higher detection rate of thyroid cancers within existing thyroid nodules. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) 2023 and the American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS) are first-line investigations for thyroid nodules, aiding in diagnosis and management decisions.
To evaluate the concordance between TBSRTC 2023 and ACR-TIRADS in reporting thyroid lesions and assess their accuracy in diagnosing malignancies.
This retrospective, laboratory data-based study included patients presenting with thyroid nodules, who underwent ultrasonography and fine needle aspiration cytology (FNAC), followed by thyroidectomy. Overall concordance between TBSRTC, ACR-TIRADS, and histopathologic diagnosis was evaluated, along with their diagnostic accuracy. Risk of malignancy (ROM) was calculated for both systems using the final HPE diagnosis.
115 patient records were analyzed. Interobserver agreement between TBSRTC and ACR-TIRADS was moderate (kappa = 0.493 ± 0.093 [±SE]). ROM across extremes of TBSRTC and TIRADS categories were found to be similar. Higher TBSRTC grades correlated with higher ACR-TIRADS grades (Spearman's rank correlation coefficient = 0.594, P = 4.5 × 10 -16). The accuracy of FNAC findings and TIRADS to predict malignancy was 84.35% versus 80.87%, with no statistically significant difference (P = 0.644).
Our findings suggest a good concordance between both reporting systems for thyroid nodules, with moderate interrater agreement. Both systems are equally useful for surgical decision-making and avoiding unnecessary surgeries.
诊断技术的最新进展使得在现有的甲状腺结节中甲状腺癌的检出率更高。2023年甲状腺细胞病理学报告贝塞斯达系统（TBSRTC）和美国放射学会甲状腺影像报告和数据系统（ACR-TIRADS）是甲状腺结节的一线检查方法，有助于诊断和管理决策。
评估2023年TBSRTC和ACR-TIRADS在报告甲状腺病变方面的一致性，并评估它们在诊断恶性肿瘤方面的准确性。
这项基于实验室数据的回顾性研究纳入了出现甲状腺结节的患者，这些患者接受了超声检查和细针穿刺细胞学检查（FNAC），随后进行了甲状腺切除术。评估了TBSRTC、ACR-TIRADS和组织病理学诊断之间的总体一致性及其诊断准确性。使用最终的组织病理学检查（HPE）诊断计算两个系统的恶性风险（ROM）。
分析了115份患者记录。TBSRTC和ACR-TIRADS之间的观察者间一致性为中等（kappa = 0.493±0.093[±标准误]）。发现TBSRTC和TIRADS类别两端的ROM相似。较高的TBSRTC分级与较高的ACR-TIRADS分级相关（斯皮尔曼等级相关系数 = 0.594，P = 4.5×10-16）。FNAC结果和TIRADS预测恶性肿瘤的准确性分别为84.35%和80.87%，无统计学显著差异（P = 0.644）。
我们的研究结果表明，两种甲状腺结节报告系统之间具有良好的一致性，观察者间一致性中等。这两种系统在手术决策和避免不必要的手术方面同样有用。
