TY - JOUR
T1 - Assessment of the Bethesda System for Reporting Thyroid Cytopathology
AU - Sauter, Jennifer L.
AU - Lehrke, Heidi
AU - Zhang, Xiaotun
AU - Al Badri, Osamah T.
AU - Rodriguez-Gutierrez, Rene
AU - Delivanis, Danae A.
AU - Singh Ospina, Naykky
AU - Donegan, Diane
AU - Hamidi, Oksana
AU - Iñiguez-Ariza, Nicole
AU - Sharma, Anu
AU - Kittah, Nana Esi N.
AU - Tamhane, Shrikant U.
AU - Hurtado Andrade, Maria D.
AU - Kotwal, Anupam
AU - Jenkins, Sarah M.
AU - Spears, Grant
AU - Rivera, Michael
AU - Dean, Diana S.
AU - Henry, Michael R.
N1 - Funding Information:
Acknowledgments: We thank Allyne Manzo for technical assistance with figure design.This work was supported by departmental funding from the Division of Anatomic Pathology, Mayo Clinic, Rochester, MN.
Publisher Copyright:
© 2019 American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2019/9/9
Y1 - 2019/9/9
N2 - Objectives: Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods: Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results: Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions: Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.
AB - Objectives: Long-term follow-up is important for determining performance characteristics of thyroid fine-needle aspiration (FNA). Methods: Histologic or 3 or more years of clinical follow-up was used to calculate performance characteristics of thyroid FNA before and after implementation of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) classification was also investigated. Results: Follow-up was obtained for 1,277/1,134 and 1,616/1,393 aspirates/patients (median clinical follow-up, 9.9 and 4.4 years, pre- and post-TBSRTC, respectively). Nondiagnostic, suspicious for follicular neoplasm, and suspicious for malignancy (SFM) diagnoses decreased and benign diagnoses increased post-TBSRTC, while atypical rate remained less than 1%. Negative predictive value for benign nodules and positive predictive value (PPV) for SFM increased significantly. Eleven nodules were reclassified as NIFTP, slightly decreasing PPV/risk of malignancy (ROM). Conclusions: Appropriate ROM for thyroid FNA can be achieved through application of TBSRTC terminology with minimal use of atypical category.
KW - Atypia of undetermined significance/follicular lesion of undetermined significance
KW - Bethesda
KW - Cytopathology
KW - FNA
KW - Fine-needle aspiration
KW - Follicular neoplasm/suspicious for follicular neoplasm
KW - Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)
KW - Papillary thyroid carcinoma
KW - Risk of malignancy
KW - Thyroid
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U2 - 10.1093/ajcp/aqz076
DO - 10.1093/ajcp/aqz076
M3 - Article
C2 - 31305880
AN - SCOPUS:85071998406
SN - 0002-9173
VL - 152
SP - 502
EP - 511
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 4
ER -