Thyroid fine-needle aspiration cytology in Taiwan: a nationwide survey and literature update

Abstract

Fine-needle aspiration (FNA) is minimally invasive and widely used for assessing thyroid nodules [1]. It is also a decisive procedure for evaluating thyroid nodules that require surgery or conservative management [2,3]. Although the Bethesda System is the most widely accepted diagnostic system for thyroid cytology, there are significant deviations in practices in different countries [4,5]. Our previous review summarized the history and the evolution of the thyroid FNA practice in Taiwan [6]. The aims of this article are to provide an overview of the current thyroid FNA practice in Taiwan, particularly data from our nationwide survey, describe the changes due to the new World Health Organization (WHO) classification, and the advances of novel technologies. CURRENT THYROID CYTOPATHOLOGY IN TAIWAN In Taiwan, the majority of thyroid FNA cases are now performed with ultrasound guidance, since ultrasound-guided FNA provides better sampling of smaller or multiple nodules compared to palpation-guided FNA. High-resolution neck ultrasonography provides a simple, real-time, and noninvasive method to assess thyroid nodules. The accuracy of neck ultrasonography

Diagnostic values of SurePath liquid‐based cytology versus conventional smear in thyroid aspiration samples: A 13‐year experience at a single institution

“…However, our high ND/UNS rate was consistent with the result of a high unsatisfactory rate (24.04%) in a nationwide survey from our country. 25 The high unsatisfactory rate might be attributable to the routine submission of the fluid from symptomatic hemorrhagic cysts for cytologic examination in our clinical practice. In addition, the prevalence of thyroid abnormalities detected by ultrasonography in Taiwanese adults without palpable thyroid nodules was 18.5%, which were mostly cysts and small nodules.…”

“…However, our low FN/SFN rate was consistent with the FN/SFN rate (0.35%) in a nationwide survey from our country. 25 This variation can be explained by the fact that the prevalence of follicular variant papillary thyroid carcinoma (FVPTC) was reported to be much higher in Western than Asian countries. 20,29 Many encapsulated FVPTCs, recently classified as NIFTP, are cytologically diagnosed as FN/SFN.…”

Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: its updated diagnostic criteria, preoperative cytologic diagnoses and impact on the risk of malignancy

“…While the impact of NIFTP was suspected considerable in European and North American countries due to the high incidence of NIFTP, it does not seem to be the same in Asian counterparts. Compared with European and North American countries, Asian countries generally have reported lower incidence of NIFTPs [ 22 , 46 , 47 ]. Indeed, results from studies including Asian multi-institutional study performed by Bychkov et al [ 48 ] indicate that magnitude of ROM decrease was slight and not significant [ 47 ].…”

“…Compared with European and North American countries, Asian countries generally have reported lower incidence of NIFTPs [ 22 , 46 , 47 ]. Indeed, results from studies including Asian multi-institutional study performed by Bychkov et al [ 48 ] indicate that magnitude of ROM decrease was slight and not significant [ 47 ]. A meta-analysis performed by Vuong et al [ 49 ] compared the ROM decrease in Asian regions to Western counterparts and found that the decrease in ROM in each category is generally lower in Asian countries, with the greatest difference in SM category (5% vs. 18%), followed by AUS/FLUS category (8% vs. 10%).…”

Identification of NIFTP-Specific mRNA Markers for Reliable Molecular Diagnosis of Thyroid Tumors

“…Additionally, gene fusions involving PPARG and THADA genes have been identified [ 1 , 6 , 8 ]. In cytologic specimens, NIFTP is often indistinguishable from benign or malignant follicular-cell derived thyroid neoplasms with RAS -like molecular profiles [ 9 – 12 ].…”