Diagnostic relevance of fine needle aspiration cytology in nodular thyroid lesions

Knezevic-Usaj, Slavica; Eri, Živka; Panjković, Milana; Klem, Istvan; Ivković-Kapicl, Tatjana; Karapandzic, Aleksandra; Jelic, Jasmina

doi:10.2298/vsp1207555k

Cited by 4 publications

(6 citation statements)

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“…In a Serbian study involving 266 patients with thyroid swelling, histopathologic correlation was done in 69 patents that later on underwent surgery. They found thyroid carcinoma in 10 patients with an overall accuracy of 97% [ 8 ]. Himakhm et al in a hospital based study of 469 patients found malignancy in 179 cases, out of which 147 cases were that of papillary carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective

et al. 2014

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IntroductionThyroid swelling is common problem among South Asian women. Although benign nodules far outnumber cancerous lesions, the risk of malignancy needs to be evaluated preoperatively for which fine needle aspiration cytology (FNAC) is widely used. Bethesda system for reporting thyroid cytopathology (BSRTC) was introduced to streamline the reporting of thyroid aspirates. We aimed to evaluate the disease spectrum of thyroid cytopathology and correlation of BSRTC with final histopathology in our setup.MethodsThe study was conducted at Histopathology department of Liaquat National Hospital, Karachi, involving 528 patients with thyroid swelling who underwent FNAC. Out of these 528 cases, 61 patients subsequently underwent surgical excision. Results of final histopathology were correlated with cytologic diagnosis.ResultsMean age of the patients included in the study was 39.7 ± 13(14–84) and male to female ratio was 1:3.6. Out of total 528 cases, 403 cases were diagnosed as benign (Bethesda 2) and 67 were Bethesda 3 (follicular lesion of undetermined significance, FLUS) while 22 cases were categorized as either malignant or suspicious for malignancy (Bethesda 6 and 5). Histopathologic correlation was done in 61 cases. For Bethesda 5 and 6 categories, 100% concordance was found, however for Bethesda 2 category, 5 out of 45 cases were found to have malignant diagnosis on final histopathology. The incidence of malignancy in Bethesda categories 2 through 4 were 11.1%, 33.4%, 25%, 100% and 100% respectively. Overall accuracy of FNA cytology was 80.3% with 64.3% sensitivity and 85.1% specificity.ConclusionOur study validated the accuracy of BSRTC in our setup. Therefore we recommend routine use of BSRTC for reporting thyroid cytopathology for initial workup of patients with thyroid nodule. However, risk of malignancy was found to be significantly high in Bethesda 3 category to warrant further workup including ultrasound/thyroid scan in addition to repeat FNAC.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective

et al. 2014

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“…Usually, diagnosing thyroid nodules as benign or malignant is performed by cytological evaluation (5). For this purpose, fine-needle aspiration (FNA) is the most commonly used sample extraction technique, since it is rapid, inexpensive and simple, as shown by Knezević-Usaj et al (6). Subsequent cytological analysis following FNA provides four possible results: nondiagnostic, positive to malignancy or suspicious, indeterminate and benign cytology (7).…”

Section: Introductionmentioning

confidence: 99%

A robust biomarker of differential correlations improves the diagnosis of cytologically indeterminate thyroid cancers

Gómez-Rueda

Palacios-Corona

Gutiérrez-Hermosillo

et al. 2016

International Journal of Molecular Medicine

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The fine-needle aspiration of thyroid nodules and subsequent cytological analysis is unable to determine the diagnosis in 15 to 30% of thyroid cancer cases; patients with indeterminate cytological results undergo diagnostic surgery which is potentially unnecessary. Current gene expression biomarkers based on well-determined cytology are complex and their accuracy is inconsistent across public datasets. In the present study, we identified a robust biomarker using the differences in gene expression values specifically from cytologically indeterminate thyroid tumors and a powerful multivariate search tool coupled with a nearest centroid classifier. The biomarker is based on differences in the expression of the following genes: CCND1, CLDN16, CPE, LRP1B, MAGI3, MAPK6, MATN2, MPPED2, PFKFB2, PTPRE, PYGL, SEMA3D, SERGEF, SLC4A4 and TIMP1. This 15-gene biomarker exhibited superior accuracy independently of the cytology in six datasets, including The Cancer Genome Atlas (TCGA) thyroid dataset. In addition, this biomarker exhibited differences in the correlation coefficients between benign and malignant samples that indicate its discriminatory power, and these 15 genes have been previously related to cancer in the literature. Thus, this 15-gene biomarker provides advantages in clinical practice for the effective diagnosis of thyroid cancer.

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“…If the method is correctly performed, cytological material adequately processed and the results interpreted by an experienced cytopathologist, FNA provides reliable information about the disease before surgical treatment 12,13 . If the method is correctly performed, cytological material adequately processed and the results interpreted by an experienced cytopathologist, FNA provides reliable information about the disease before surgical treatment 12,13 .…”

Section: Discussionmentioning

confidence: 99%

“…In such cases, the correlation of clinical and radiological images and the content of the sample can help to reduce the number of "unsatisfactory" samples 1,13,22 . Evaluation of the adequacy is a job of a cytopathologist, who based on the present material determines whether the definitive diagnosis and interpretation can be made.…”

Section: Discussionmentioning

confidence: 99%

“…The determined parameters are recommended by the UK NHSBSP, which are used for assessing the performance of FNA/FS diagnostic methods in lesions of salivary glands (analogous to lesions in other organs): absolute sensitivity, complete sensitivity, specificity, positive predictive value, false negative relationship, false positive ratio, an inadequate ratio and inadequate ratio of cancers 12,13 .…”

Section: Methodsmentioning

confidence: 99%

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Reliability of fine needle aspiration and ex tempore biopsy in the diagnosis of salivary glands lesions

et al. 2014

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Diagnostic relevance of fine needle aspiration cytology in nodular thyroid lesions

Abstract: The obtained results confirm the importance of FNAC in preoperative assesment of thyroid nodule.

Cited by 4 publications

References 17 publications

Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective

Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective

A robust biomarker of differential correlations improves the diagnosis of cytologically indeterminate thyroid cancers

Reliability of fine needle aspiration and ex tempore biopsy in the diagnosis of salivary glands lesions

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