The Bethesda System for Reporting Thyroid Cytopathology in the African American population: A tertiary centre experience

IF 1.2 4区医学 Q4 CELL BIOLOGY Cytopathology Pub Date : 2024-07-29 DOI:10.1111/cyt.13426

Carla Saoud, Gabrielle E. Bailey, Ashleigh J. Graham, Zahra Maleki

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Abstract

Background

The reported risk of malignancies (ROM) remains controversial for fine needle aspiration (FNA) of thyroid nodules in the African American (AA) population. Herein, the ROM along with frequency was assessed for each of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) diagnostic categories.

Materials and Methods

The electronic pathology archive of a large academic hospital was retrospectively searched for cytopathology reports of thyroid nodules in AA patients (2010–2019) and Non-African American (NAA) control cases. The patients' demographic, thyroid nodule characteristics, FNA results using TBSRTC and surgical diagnoses were recorded, whenever available.

Results

Three hundred ninety-one cases were identified, 317 females (81.1%) and 74 males (18.9%) with median age 50.0 (SD = 14.4). The mean size of the nodules was 2.1 cm (SD = 1.4). The Bethesda categories were: 5.4% (I), 35.0% (II), 35.3% (III), 7.7% (IV), 3.3% (V) and 13.3% (VI). The overall ROM of thyroid nodules was 43.8% (89/203) on surgical follow-up (203/391). The ROM in each Bethesda categories were: 33.3% (I), 11.6% (II), 35.2% (III), 15.8% (IV), 83.3% (V) and 100% (VI) on surgical follow-up. The frequency of thyroid nodules was higher in AA females; however, the ROM was higher in AA males (48.3%) compared with AA females (41.2%).

Conclusion

The ROM in Categories I, II and III was higher than those reported in the TBSRTC while being similar in Categories IV, V and VI. The overall risk of thyroid malignancy in our AA patient population was higher than those in the literature. The overall ROM of thyroid nodules in AA males was higher than of AA females.

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非裔美国人甲状腺细胞病理学报告贝塞斯达系统：一个三级中心的经验。

背景：关于非裔美国人（AA）甲状腺结节细针穿刺（FNA）的恶性肿瘤风险（ROM）仍存在争议。在此，我们评估了贝塞斯达甲状腺细胞病理学报告系统（TBSRTC）各诊断类别的恶性肿瘤风险及发生频率：对一家大型学术医院的电子病理档案进行了回顾性检索，以获得AA患者（2010-2019年）和非非洲裔美国人（NAA）对照病例的甲状腺结节细胞病理学报告。只要有患者的人口统计学特征、甲状腺结节特征、使用TBSRTC的FNA结果和手术诊断结果，就会记录在案：共发现 391 例患者，其中女性 317 例（81.1%），男性 74 例（18.9%），中位年龄为 50.0 岁（SD = 14.4）。结节的平均大小为 2.1 厘米（SD = 1.4）。贝塞斯达分类为5.4%（Ⅰ）、35.0%（Ⅱ）、35.3%（Ⅲ）、7.7%（Ⅳ）、3.3%（Ⅴ）和13.3%（Ⅵ）。在手术随访（203/391）中，甲状腺结节的总ROM为43.8%（89/203）。贝塞斯达分级的ROM分别为手术随访时，各Bethesda分类的ROM分别为：33.3%（I）、11.6%（II）、35.2%（III）、15.8%（IV）、83.3%（V）和100%（VI）。甲状腺结节的发生率在AA女性中较高，但AA男性的ROM（48.3%）高于AA女性（41.2%）：结论：I、II和III类甲状腺结节的ROM高于TBSRTC报告的ROM，而IV、V和VI类甲状腺结节的ROM与TBSRTC报告的ROM相似。在我们的 AA 患者群体中，甲状腺恶性肿瘤的总体风险高于文献报道。AA男性甲状腺结节的总ROM高于AA女性。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.