超声甲状腺影像报告和数据系统（TIRADS）及甲状腺细胞病理学Bethesda报告系统在直径小于4.0 cm甲状腺结节中的诊断效用：一项回顾性分析

The diagnostic utility of the ultrasound TIRADS and Bethesda System of reporting thyroid cytology in thyroid nodule smaller than 4.0 cm: A retrospective analysis.

作者信息

Hagag Howaida M, Ismail Khadiga A, Bakhuraysah Maha M, Nagi Ali, Hasan Abdulkarim, Ahmed Ali Sabrine Ali, AlThagafi Tahani M, Alsofuni Mona Abdullah M, Altalhi Alaa Khader S, Altalhi Amjad Ayidh, Althagafi Salman Muidh A, Ramadan Karim A, Marzouk Usama M, Alghamdi Fahad A, Baloush Razan Abed A, Bawahab Ahmed Abdulwahab, Soltan Hassan A, Elfeshawy Mohamed Salah, Samih Tamer A A

机构信息

Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.

Department of General Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

出版信息

Medicine (Baltimore). 2025 Jul 25;104(30):e43264. doi: 10.1097/MD.0000000000043264.

DOI:10.1097/MD.0000000000043264

PMID:40725946

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12303486/

Abstract

Thyroid nodules (TNs) are a common clinical issue, prevalent in the general population. Fine-needle aspiration cytology (FNAC) is a vital diagnostic tool for the initial evaluation of TNs. This study aimed to determine the cytopathological patterns of thyroid nodules using the Bethesda System for Reporting Thyroid Cytology (TBSRTC) and to assess the diagnostic role of both FNAC and ultrasonography in TNs <4 cm in diameter. This study included 100 FNAC samples from thyroid nodules. Patients underwent ultrasonographic examination, with findings reported according to the European Thyroid Imaging Reporting and Data System. FNAC samples were stained using Diff-Quik and Papanicolaou stains, cytologically examined, and reported according to TBSRTC. Histopathological assessment was performed using hematoxylin and eosin staining of the corresponding excised biopsies. The patterns were analyzed and the results correlated. The mean age of the participants was 46.2 ± 12.7 years, with females comprising 89% of the cases. About half (51%) of the nodules were in the right lobe. The diameter of the nodules ranged from 8 to 40 mm, with a mean diameter of 20.3 mm. Normal thyroid-stimulating hormone levels were observed in 74% of cases with no significant association between thyroid-stimulating hormone levels and nodule characteristics. Among the 100 FNACs, 54% were categorized as Bethesda II, 25% as Bethesda III, 8% as Bethesda IV, and 2% as Bethesda V. A significant correlation was found between cytopathological diagnoses and both ultrasonographic (P = .001) and histopathological (P = .05) diagnoses. We concluded that the benign conditions were the most common cytopathological findings. FNAC reporting using TBSRTC demonstrated a strong correlation with ultrasonographic and histopathological diagnoses, confirming its reliability and high diagnostic value in evaluating small thyroid nodules.

摘要

甲状腺结节（TNs）是一个常见的临床问题，在普通人群中普遍存在。细针穿刺细胞学检查（FNAC）是对甲状腺结节进行初步评估的重要诊断工具。本研究旨在使用甲状腺细胞病理学报告贝塞斯达系统（TBSRTC）确定甲状腺结节的细胞病理学模式，并评估FNAC和超声检查在直径<4 cm的甲状腺结节中的诊断作用。本研究纳入了100份甲状腺结节的FNAC样本。患者接受了超声检查，检查结果根据欧洲甲状腺影像报告和数据系统进行报告。FNAC样本采用Diff-Quik和巴氏染色法染色，进行细胞学检查，并根据TBSRTC进行报告。使用苏木精和伊红染色对相应的切除活检组织进行组织病理学评估。对模式进行分析并将结果进行关联。参与者的平均年龄为46.2±12.7岁，其中女性占病例的89%。约一半（51%）的结节位于右叶。结节直径范围为8至40 mm，平均直径为20.3 mm。74%的病例甲状腺刺激激素水平正常，甲状腺刺激激素水平与结节特征之间无显著关联。在100份FNAC样本中，54%被归类为贝塞斯达II类，25%为贝塞斯达III类，8%为贝塞斯达IV类，2%为贝塞斯达V类。发现细胞病理学诊断与超声检查（P = .001）和组织病理学诊断（P = .05）之间存在显著相关性。我们得出结论，良性情况是最常见的细胞病理学发现。使用TBSRTC进行FNAC报告与超声检查和组织病理学诊断显示出很强的相关性，证实了其在评估小甲状腺结节方面的可靠性和高诊断价值。