Aim: To evaluate the effectiveness of the Bethesda system for reporting thyroid cytopathology in the prediction of thyroid cancer on fine needle aspiration (FNA).
Materials and methods: This is retrospective study of 70 detected thyroid cancer. Thyroid ultrasound and FNA were performed on all patients. 66 of them with cancer suspicion were communicated to the thyroid surgeon, 4 cases of papillary carcinoma were accidentally diagnosed after hystological investigation. 65 patients underwent total thyroidectomy with or without lymph node dissection. One patient refused surgical treatment. 69 intraoperative samples were subjected to hystological examination.
Results: In the group with cancer suspicion category VI by TBSRTC was assigned in 51 (77.3%) cases, category V in 13 (19.7%) cases, 1 case (1.5%) with category V and VI with multinodular goitre, and 1 case (1.5%) with category VI and IV with multinodular goitre too. Hystological examination of 60 (91%) cases confirmed thyroid cancer: papillary carcinoma in 56 (85%) cases; medullary carcinoma in 3 (4.5%) cases; mixed follicular and papillary carcinoma in 1 (1.5%) case. In 6 (9%) cases the cancer wasnt detected. 2 (3%) of these 6 cases were classified as category VI and 4 cases (6%) as category V. Thyroid cancer was not detected in all the cases of categories II-III found after thyroidectomy for other reasons.
Conclusion: Category VI corresponds with 97% of diagnosed thyroid cancer, and category V - 94%. Thyroid cancer was confirmed in only 4 of all cases with category IV. This result indicates the need for additional diagnostic methods in the preoperative period for category IV for which molecular genetic tests may have potential. To determine the risk of malignancy of thyroid nodules with categories II-III requires long-term monitoring.
20 - 23 May 2017
European Society of Endocrinology