Yıl: 2020 Cilt: 45 Sayı: 3 Sayfa Aralığı: 1173 - 1181 Metin Dili: İngilizce DOI: 10.17826/cumj.733150 İndeks Tarihi: 23-12-2021

Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis

Öz:
Purpose: The thyroid fine needle aspiration cytology (FNAC) is a fast, reliable, and economical method for the interpretation of thyroid nodules. This method contributes to the later management of patients and reduces unnecessary surgical interventions. This study aimed to demonstrate the contribution of bedside adequacy assessment during FNAC to the accuracy rates of cytological competence and final histological diagnosis. Materials and Methods: The study included 443 patients who underwent FNAC in a university hospital between 2012 and 2015. Correlations between the histological diagnosis categories of patients who had and who did not have bedside adequacy assessment were compared per sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Results: As a result of comparison of cytological and histopathological diagnoses, 30.7% sensitivity, 75% specificity, 50% positive predictive value, 57.1% negative predictive value and 55.1% diagnostic accuracy were found in the group with bedside adequacy assesment. Whereas in the group without bedside adequacy assessment, 50% sensitivity, 69.2% specificity, 42.8% positive predictive value, 75% negative predictive value, and 63.1% diagnostic accuracy were found Conclusion: Bedside adequacy assessment increases the cytological adequacy proportion, but does not contribute to the diagnostic accuracy rate.
Anahtar Kelime:

Tiroid sitolojisinde hasta başı yeterlilik çalışmasının sitolojik yeterlilik ve kalıcı histopatolojik tanıya etkisi

Öz:
Amaç: Tiroid ince iğne aspirasyon sitolojisi (İİAS), tiroid nodüllerinin değerlendirilmesi için; hızlı, güvenilir, ekonomik bir yöntemdir. Bu yöntem hastaların ileri dönemde yönetimine katkı sağlamakta ve gereksiz cerrahi uygulamaları azaltmaktadır. Bu çalışmada İİAS sırasında, hasta başında yeterlilik değerlendirilmesinin, sitolojik yeterlilik ve histolojik kesin tanıda doğruluk oranlarına ne kadar katkısı olduğunu göstermek amaçlandı. Gereç ve Yöntem: Çalışmaya, 2012-2015 yılları arasında, bir üniversite hastanesinde İİAS uygulanmış 443 hasta dâhil edilmiştir. Hasta başında yeterlilik değerlendirilen ve değerlendirilmeyen olguların histolojik tanı kategorileriyle korelasyonu; duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörü değeri, tanısal doğruluk oranlarına göre karşılaştırılmıştır. Bulgular: Sitolojik ve histopatolojik tanıların karşılaştırılması sonucunda, hasta başı yeterlilik değerlendirilen grupta, duyarlılık %30,7, özgüllük %75, pozitif öngörü değeri %50, negatif öngörü değeri %57,1, tanısal doğruluk %55,1 olarak bulunmuştur. Hasta başı yeterlilik değerlendirilmeyen grupta ise duyarlılık %50, özgüllük %69,2, pozitif öngörü değeri %42,8 negatif öngörü değeri %75, tanısal doğruluk %63,1 olarak bulunmuştur. Sonuç: Hasta başı yeterlilik değerlendirilmesi, sitolojik yeterlilik oranını arttırır, ancak tanısal doğruluk oranına katkıda bulunmaz.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012;96:329-49.
  • 2. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22:901-11.
  • 3. Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME et al. American association of clinical endocrinologists and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006;12:63-102.
  • 4. Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91:3411-17.
  • 5. DeMay RM. The Art and Science of Cytopathology: Superficial Aspiration Cytology. 2nd ed. Chicago, IL: ASCP Press. 2012.
  • 6. Orell SV, Sterrett GF. Orell and Sterrett’s Fine Needle Aspiration Cytology. 5th ed. Edinburgh, Churchill Livingstone Elsevier, 2012.
  • 7. De Koster EJ, Kist JW, Vriens MR, Borel Rinkes IHM, Valk GD, De Keizer B. Thyroid ultrasoundguided fine-needle aspiration: the positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate. Acta Cytol. 2016;60:39-45.
  • 8. Hegedus L. Clinical practice: The thyroid nodule. N Engl J Med. 2004;351:1764–71.
  • 9. Simsek GG, Ertuğrul DT, Guresci S, Şimşek H. Is there a role for on-site evaluation of thyroid fine needle aspiration to reduce the nondiagnostic rate? Endocr Pathol. 2013;24:57-61.
  • 10. Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid. 1998;8:15–21.
  • 11. Cibas ES, Ali SZ. The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid. 2017;27:1341-6.
  • 12. Shield PW, Cosier J, Ellerby G, Gartrell M, Papadimos D. Rapid onsite evaluation of fine-needle aspiration specimens by cytology scientists: a review of 3032 specimens. Cytopathology. 2014;25:322-9.
  • 13. İnan G, Sert S, Bircan S, et al. Tiroid lezyonlarında tiroid ince iğne aspirasyon biyopsisi ve histopatoloji sonuçlarının karşılaştırılması. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2006;13:27-31.
  • 14. Goldstein RE, Netterville JL, Burkey B et al. Implications of follicular neoplasms, atypia, and lesions suspicious for malignancy diagnosed by fineneedle aspiration of thyroid nodules. Ann Surg. 2002;235:656-64.
  • 15. Eedes CR, Wang HH. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations. Am J Clin Pathol. 2004;121:64-9.
  • 16. Ali SZ, Cibas ES. The Bethesda System for Reporting Thyroid Cytopathology (Çev.Ed: Önder S) İstanbul, Nobel Medical, 2012.
  • 17. Layfield LJ, Abrams J, Cochand-Priollet B, Evans D, Gharib H, Greenspan F et al. Post-thyroid FNA testing and treatment options: A synopsis of the National Cancer Institue. Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol. 2008;36:442-8.
  • 18. Ghofrani M, Beckman D, Rimm DL. The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience. Cancer. 2006;108:110-3.
  • 19. Crothers BA, Henry MJ, Auger M. Dialogue on thyroid disease reporting and management. CAP Today, 2008;22:48.
  • 20. Cowling P, Chandra A, Giles T. Guidance on the Reporting of Thyroid Cytology Specimens. London, Royal College of Pathologists, 2009.
  • 21. Baloch ZW, Tam D, Langer J, Mandel S, LiVolsi VA, Gupta PK. Ultrasound guided fine needle aspiration biopsy of the thyroid: Role of onsite assessment and multiple cytologic preparations. Diagn Cytopathol. 2000;23:425-9.
  • 22. Baloch ZW, Sack MJ, Yu GH, Lıvolsı V A, Gupta PK. Fine-needle aspiration of thyroid: an institutional experience. Thyroid. 1998;8:565-9.
  • 23. Schmidt RL, Witt BL, Lopez-Calderon LE, Layfield LJ. The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology. Am J Clin Pathol. 2013;139:300-8.
  • 24. Önver H, Özbey AO, Duymuş M, Yılmaz Ö, Koşar PN. Tiroit nodüllerinin ultrasonografik, sitolojik ve histopatolojik bulgularının incelenmesi. Kafkas Tıp Bilimleri Dergisi. 2013;3:80-7.
  • 25. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007;111:306-15.
  • 26. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol. 2012;56:333-9.
  • 27. Theoharis CG, Schofield KM, Hammers L, Udelsman R, Chhieng DC. The Bethesda thyroid fine-needle aspiration classification system: year 1 at an academic institution. Thyroid. 2009;19:1215-23.
  • 28. Her‐Juing Wu H, Rose C, Elsheikh TM. The Bethesda system for reporting thyroid cytopathology: an experience of 1,382 cases in a community practice setting with the implication for risk of neoplasm and risk of malignancy. Diagn Cytopathol. 2012;40:399- 403.
  • 29. Bagga PK, Mahajan NC. Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it? Indian J Cancer. 2010;47:437-42.
  • 30. Jo VY, Stelow EB, Dustin SM, Hanley KZ. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for reporting thyroid cytopathology. Am J Clin Pathol. 2010;134:450-6.
  • 31. Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA et al. Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer. 2007;111:508-16.
  • 32. Muratli A, Erdogan N, Sevim S, Unal I, Akyuz S. Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules. J Cytol. 2014;31:73-8.
  • 33. Pandey P, Dixit A, Mahajan NC. Fine-needle aspiration of the thyroid: A cytohistologic correlation with critical evaluation of discordant cases. Thyroid Research and Practice. 2012;9:32-9.
  • 34. Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid: a review of 6226 cases and correlation with surgical or clinical outcome. Arch Pathol Lab Med. 2001;125:484-8.
APA Toyran T, GÜVENDİ G, ADALI Y, Üstün H (2020). Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. , 1173 - 1181. 10.17826/cumj.733150
Chicago Toyran Tugba,GÜVENDİ Gülname Fındık,ADALI Yasemen,Üstün Hüseyin Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. (2020): 1173 - 1181. 10.17826/cumj.733150
MLA Toyran Tugba,GÜVENDİ Gülname Fındık,ADALI Yasemen,Üstün Hüseyin Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. , 2020, ss.1173 - 1181. 10.17826/cumj.733150
AMA Toyran T,GÜVENDİ G,ADALI Y,Üstün H Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. . 2020; 1173 - 1181. 10.17826/cumj.733150
Vancouver Toyran T,GÜVENDİ G,ADALI Y,Üstün H Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. . 2020; 1173 - 1181. 10.17826/cumj.733150
IEEE Toyran T,GÜVENDİ G,ADALI Y,Üstün H "Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis." , ss.1173 - 1181, 2020. 10.17826/cumj.733150
ISNAD Toyran, Tugba vd. "Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis". (2020), 1173-1181. https://doi.org/10.17826/cumj.733150
APA Toyran T, GÜVENDİ G, ADALI Y, Üstün H (2020). Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. Cukurova Medical Journal, 45(3), 1173 - 1181. 10.17826/cumj.733150
Chicago Toyran Tugba,GÜVENDİ Gülname Fındık,ADALI Yasemen,Üstün Hüseyin Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. Cukurova Medical Journal 45, no.3 (2020): 1173 - 1181. 10.17826/cumj.733150
MLA Toyran Tugba,GÜVENDİ Gülname Fındık,ADALI Yasemen,Üstün Hüseyin Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. Cukurova Medical Journal, vol.45, no.3, 2020, ss.1173 - 1181. 10.17826/cumj.733150
AMA Toyran T,GÜVENDİ G,ADALI Y,Üstün H Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. Cukurova Medical Journal. 2020; 45(3): 1173 - 1181. 10.17826/cumj.733150
Vancouver Toyran T,GÜVENDİ G,ADALI Y,Üstün H Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis. Cukurova Medical Journal. 2020; 45(3): 1173 - 1181. 10.17826/cumj.733150
IEEE Toyran T,GÜVENDİ G,ADALI Y,Üstün H "Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis." Cukurova Medical Journal, 45, ss.1173 - 1181, 2020. 10.17826/cumj.733150
ISNAD Toyran, Tugba vd. "Effects of bedside adequacy assessment in thyroid cytology on cytological sufficiency and the final histopathological diagnosis". Cukurova Medical Journal 45/3 (2020), 1173-1181. https://doi.org/10.17826/cumj.733150