To Establish Bethesda System for Diagnosis of Thyroid Nodules on the Basis of Fnac with Histopathological Correlation
Introduction: In October 2007, “The National Cancer Institute (NCI), Thyroid Fine Needle Aspiration State of the Science Conference” was held in Bethesda, Maryland hosted by the NCI with the intention of formulating internationally acceptable guidelines for reporting of thyroid cytopathology. Th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/6897/14823_CE[Ra1]_F(AK)_PF1(BMAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: In October 2007, “The National Cancer Institute
(NCI), Thyroid Fine Needle Aspiration State of the Science
Conference” was held in Bethesda, Maryland hosted by the
NCI with the intention of formulating internationally acceptable
guidelines for reporting of thyroid cytopathology. This was
because, thyroid FNAC have a reporting confusion due to
multiplicity of category terminologies. To overcome this, The
Bethesda System for Reporting Thyroid Cytopathology
(TBSRTC) was introduced for unifying the terminology and
morphologic criteria along with the corresponding risk of
malignancy. The Bethesda system for reporting thyroid
cytopathology represents a major step towards standardization,
reproducibility, improved clinical significance, and greater
predictive value of thyroid fine needle aspirates (FNAs).
Aim: The aim of this study was to elucidate the diagnostic utility
of the Bethesda system in reporting thyroid FNAs and to assess
the effectiveness of FNAC in the evaluation of thyroid nodules
by comparing the results with histopathological evaluation.
Materials and Methods: The present study was carried out
in our institute during the July 2012 to September 2014. In
this study, 100 FNACs done which were classified according
to the Bethesda system and out of them, 60 histopathological
evaluations obtained from this group were evaluated. The
sensitivity, specificity, positive and negative predictive values
were evaluated.
Results: Out of 100 FNACs, 06% were Non-diagnostic, 78%
were Benign, 04% were Atypical follicular lesion of undetermined
significance (AFLUS), 04% were suspicious for Follicular
neoplasm (SFN), 01% were suspicious for Follicular neoplasm
Hurthle cell type, 03% were suspicious for malignancy (SM), and
04% malignant. In 60 cases, data of follow-up histopathologic
examination (HPE) were available. The sensitivity was 88.89%
and specificity was 84.31%. The positive and negative predictive
value were 50% and 97.7%, respectively.
Conclusion: The Bethesda system is very useful for a
standardized system of reporting thyroid cytopathology,
improving communication between cytopathologists and
clinicians, and inter-laboratory agreement, leading to more
consistent management approaches. An additional point which
is in favor of the implementation of this system is that the
classification is directly related to the risk of malignancy in each
category, which in turn, prompts the recommended clinical
management of that category, thus truly embodying the clinicopathological correlation in its true spirit. The correlation of FNAC
with histopathology is necessary before starting treatment. |
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| ISSN: | 2249-782X 0973-709X |