Assessment of Thyroid Fine Needle Aspirates Using 2023 Bethesda System.

IF 1.6 4区医学 Q3 PATHOLOGY

Acta Cytologica Pub Date : 2025-02-25 DOI:10.1159/000544807

Niti Sureka, Charanjeet Ahluwalia, Sana Ahuja, Neha Kawatra Madan, Meetu Agrawal, Sunil Ranga

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引用次数: 0

Abstract

Background: Thyroid nodules are common, with about 5% being malignant, necessitating accurate evaluation to avoid unnecessary surgeries. Fine-needle aspiration cytology (FNAC) is a crucial diagnostic tool, and the 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) refines FNAC's diagnostic accuracy and risk stratification for thyroid lesions.

Materials and methods: This retrospective study re-classified thyroid FNAs performed at a tertiary care center from January 2023 to June 2024 using the 2023 TBSRTC and compared with available histopathological diagnoses. FNAC slides were reviewed and reclassified according to the 2023 TBSRTC categories by two cytopathologists. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy.

Results: The study included 387 patients (female-to-male ratio of 4:1), with 8% non-diagnostic, 61.5% benign, 9% AUS, 7.5% FN, 8% SFM, and 6% malignant cases. Histopathological correlation was available for 190 cases, revealing 126 benign and 64 malignant lesions. Considering NIFTP as benign on histopathology, the ROM for benign, FN, and SFM categories was 10%, 38%, and 69.2%, respectively. The highest sensitivity (88.2%) was achieved when AUS, FN, SFM, and malignant categories were considered positive for malignancy. The highest diagnostic accuracy (85.4%) was observed when SFM and malignant categories were considered positive.

Conclusion: FNAC, guided by the 2023 TBSRTC, is a reliable diagnostic tool for thyroid lesions, offering high sensitivity and specificity.

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来源期刊

Acta Cytologica 生物-病理学

CiteScore

3.70

自引率

11.10%

发文量

审稿时长

4-8 weeks

期刊介绍： With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.