Objective:To evaluate the diagnostic utility of The Bethesda System for Reporting Thyroid Cytology(TBSRTC)at Peking University Cancer Hospital,the incidence of noninvasive follicular thyroid neoplasms with papillary-l...Objective:To evaluate the diagnostic utility of The Bethesda System for Reporting Thyroid Cytology(TBSRTC)at Peking University Cancer Hospital,the incidence of noninvasive follicular thyroid neoplasms with papillary-like nuclear features(NIFTP),and the impact of reclassification on cytopathological outcomes.Methods:We performed a retrospective study of thyroid fine-needle aspiration(FNA)cases between April 2014 and March 2019.The FNA results were classified according to TBSRTC.Post-surgery histological findings were followed up.Results:A total of 2,781 thyroid FNAs were performed.The incidences of the 6 diagnostic categories(DCs I-VI)were 14.8%,17.1%,15.8%,2.3%,11.6%and 38.5%,respectively.A total of 1,122 patients(40.3%)had corresponding histological results.NIFTP accounted for 0.4%of papillary thyroid carcinoma(PTC)cases,and there was no significant difference in the risk of malignancy(ROM)for each TBSRTC DC between"NIFTP=carcinoma(Ca)"and"NIFTP≠Ca".When"NIFTP=Ca",the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of TBSRTC were 98.0%,84.0%,99.4%,58.3%,and97.5%,respectively.When"NIFTP≠Ca",the sensitivity,specificity,PPV,NPV and accuracy of the TBSRTC were 98.1%,81.5%,99.3%,61.1%,and 97.5%,respectively.Conclusions:TBSRTC is effective in the preoperative diagnosis of thyroid nodules in Peking University Cancer Hospital.The impact of the reclassification of NIFTP on cytopathological outcomes is limited because of its low incidence,and the revised ROMs are not suitable for Asian patients.展开更多
Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the d...Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAF^(V600E) mutation and the Thyroid Imaging Reporting and Data System(TIRADS) classification in differentiating papillary thyroid cancers(PTCs) from benign lesions among BSRTC I, III, and V nodules.Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAF^(V600E) mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination.Results: In the BSRTC I category, BRAF^(V600E) showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAF^(V600E) were similar to those of TIRADS. In comparison to BRAF^(V600E) alone, the combination of the two methods significantly improved sensitivity(BSRTC Ⅰ:93.6% vs. 67.7%, P < 0.01; BSRTC Ⅲ: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC Ⅰ nodules(93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules(93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules(96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001).Conclusions: BRAF^(V600E) exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC Ⅰ nodules, while the two methods showed similar diagnostic value in BSRTC Ⅲ/Ⅴ nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC Ⅰ, Ⅲ, and Ⅴ nodules.展开更多
目的总结应用甲状腺细胞病理学Bethesda报告系统(The Bethesda System for Reporting Thyroid Cytopathology,TBSRTC)进行甲状腺细胞学诊断的经验,并对TBSRTC的诊断价值进行评价。方法收集四川大学华西医院病理科2010年1月至2012年12月...目的总结应用甲状腺细胞病理学Bethesda报告系统(The Bethesda System for Reporting Thyroid Cytopathology,TBSRTC)进行甲状腺细胞学诊断的经验,并对TBSRTC的诊断价值进行评价。方法收集四川大学华西医院病理科2010年1月至2012年12月期间完成甲状腺细胞学TBSRTC分级诊断的2 257个甲状腺结节的病理资料,并计算TBSRTC诊断甲状腺恶性结节的灵敏度、特异度、准确率等诊断价值指标。结果 2 257个甲状腺结节中含Ⅰ级442个,占19.6%;Ⅱ级1 184个,占52.4%;Ⅲ级216个,占9.6%;Ⅳ级38个,占1.7%;Ⅴ级172个,占7.6%;Ⅵ级205个,占9.1%。以TBSRTCⅡ级为诊断良恶性的界点,若不纳入Ⅲ级结节,则TBSRTC分级的灵敏度为93.7%(236/252),特异度为86.6%(323/373),准确率为89.4%(559/625);若将Ⅲ级结节纳入分析,则TBSRTC分级的灵敏度为94.3%(267/283),特异度为74.9%(323/431),准确率为82.6%(590/714)。结论 TBSRTC分级在笔者所在医院的应用实践表明其真实性较高,是准确和可靠的甲状腺细胞学分类诊断系统。展开更多
甲状腺细胞病理学Bethesda报告系统（The Bethesda System for Reporting Thyroid Cytopathology，TBSRTC）于2007年首次提出，2009年正式发布，是最广为接受的、规范化的甲状腺细胞病理学诊断分类依据。基于近年来甲状腺领域出现的众...甲状腺细胞病理学Bethesda报告系统（The Bethesda System for Reporting Thyroid Cytopathology，TBSRTC）于2007年首次提出，2009年正式发布，是最广为接受的、规范化的甲状腺细胞病理学诊断分类依据。基于近年来甲状腺领域出现的众多进展，2017年10月修订后的第二版TBSRTC回世。本文对新版TBSRTC的更新点做以概括和解析。展开更多
目的探讨优化细针穿刺细胞学(fine-needle aspiration cytology,FNAC)与超声诊断标准在甲状腺髓样癌(medullary carcinoma of thyroid gland,MTC)诊断方面的应用价值。方法收集29例术后病理确诊的MTC病例,回顾性分析:(1)采用美国放射学...目的探讨优化细针穿刺细胞学(fine-needle aspiration cytology,FNAC)与超声诊断标准在甲状腺髓样癌(medullary carcinoma of thyroid gland,MTC)诊断方面的应用价值。方法收集29例术后病理确诊的MTC病例,回顾性分析:(1)采用美国放射学会(American Society of Radiology,ACR)2017版超声甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)与优化的TI-RADS分类标准进行评分的得分结果与诊断准确性;(2)FNAC涂片采用Bethesda报告系统标准与优化标准的诊断准确性。结果(1)MTC结节超声检查按优化的TI-RADS分类标准评分结果为(9.07±1.87)分,优于按ACR 2017版TI-RADS分类标准的(6.52±1.65)分,差异有统计学意义(P<0.05);(2)MTC结节在优化的TI-RADS标准下超声诊断敏感度为89.7%,优于ACR 2017版TI-RADS标准下的62.1%,差异有统计学意义(P<0.05);(3)MTC结节FNAC涂片按优化的标准诊断敏感度为93.1%,优于按Bethesda报告系统标准的58.6%,差异有统计学意义(P<0.01)。结论优化超声与FNAC诊断标准可提高MTC术前的诊断准确性,对制定MTC患者的手术方式和避免再次手术以及改善其预后均有重大临床的意义。展开更多
文摘Objective:To evaluate the diagnostic utility of The Bethesda System for Reporting Thyroid Cytology(TBSRTC)at Peking University Cancer Hospital,the incidence of noninvasive follicular thyroid neoplasms with papillary-like nuclear features(NIFTP),and the impact of reclassification on cytopathological outcomes.Methods:We performed a retrospective study of thyroid fine-needle aspiration(FNA)cases between April 2014 and March 2019.The FNA results were classified according to TBSRTC.Post-surgery histological findings were followed up.Results:A total of 2,781 thyroid FNAs were performed.The incidences of the 6 diagnostic categories(DCs I-VI)were 14.8%,17.1%,15.8%,2.3%,11.6%and 38.5%,respectively.A total of 1,122 patients(40.3%)had corresponding histological results.NIFTP accounted for 0.4%of papillary thyroid carcinoma(PTC)cases,and there was no significant difference in the risk of malignancy(ROM)for each TBSRTC DC between"NIFTP=carcinoma(Ca)"and"NIFTP≠Ca".When"NIFTP=Ca",the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of TBSRTC were 98.0%,84.0%,99.4%,58.3%,and97.5%,respectively.When"NIFTP≠Ca",the sensitivity,specificity,PPV,NPV and accuracy of the TBSRTC were 98.1%,81.5%,99.3%,61.1%,and 97.5%,respectively.Conclusions:TBSRTC is effective in the preoperative diagnosis of thyroid nodules in Peking University Cancer Hospital.The impact of the reclassification of NIFTP on cytopathological outcomes is limited because of its low incidence,and the revised ROMs are not suitable for Asian patients.
基金supported by grants from the National Natural Science Foundation of China (Grant No. 81261120566)Jiangsu Province Key Medical Personnel Project (Grant No. RC2011068)+2 种基金333 Projects in the Fourth Phase of Jiangsu Province (Grant No. BRA2015389)Jiangsu Province "Six First Project" Research Program (Grant No. LGY2016004)the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAF^(V600E) mutation and the Thyroid Imaging Reporting and Data System(TIRADS) classification in differentiating papillary thyroid cancers(PTCs) from benign lesions among BSRTC I, III, and V nodules.Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAF^(V600E) mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination.Results: In the BSRTC I category, BRAF^(V600E) showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAF^(V600E) were similar to those of TIRADS. In comparison to BRAF^(V600E) alone, the combination of the two methods significantly improved sensitivity(BSRTC Ⅰ:93.6% vs. 67.7%, P < 0.01; BSRTC Ⅲ: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC Ⅰ nodules(93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules(93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules(96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001).Conclusions: BRAF^(V600E) exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC Ⅰ nodules, while the two methods showed similar diagnostic value in BSRTC Ⅲ/Ⅴ nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC Ⅰ, Ⅲ, and Ⅴ nodules.
文摘甲状腺细胞病理学Bethesda报告系统（The Bethesda System for Reporting Thyroid Cytopathology，TBSRTC）于2007年首次提出，2009年正式发布，是最广为接受的、规范化的甲状腺细胞病理学诊断分类依据。基于近年来甲状腺领域出现的众多进展，2017年10月修订后的第二版TBSRTC回世。本文对新版TBSRTC的更新点做以概括和解析。
文摘目的探讨优化细针穿刺细胞学(fine-needle aspiration cytology,FNAC)与超声诊断标准在甲状腺髓样癌(medullary carcinoma of thyroid gland,MTC)诊断方面的应用价值。方法收集29例术后病理确诊的MTC病例,回顾性分析:(1)采用美国放射学会(American Society of Radiology,ACR)2017版超声甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)与优化的TI-RADS分类标准进行评分的得分结果与诊断准确性;(2)FNAC涂片采用Bethesda报告系统标准与优化标准的诊断准确性。结果(1)MTC结节超声检查按优化的TI-RADS分类标准评分结果为(9.07±1.87)分,优于按ACR 2017版TI-RADS分类标准的(6.52±1.65)分,差异有统计学意义(P<0.05);(2)MTC结节在优化的TI-RADS标准下超声诊断敏感度为89.7%,优于ACR 2017版TI-RADS标准下的62.1%,差异有统计学意义(P<0.05);(3)MTC结节FNAC涂片按优化的标准诊断敏感度为93.1%,优于按Bethesda报告系统标准的58.6%,差异有统计学意义(P<0.01)。结论优化超声与FNAC诊断标准可提高MTC术前的诊断准确性,对制定MTC患者的手术方式和避免再次手术以及改善其预后均有重大临床的意义。
