甲状腺细胞学分类系统的比较分析:印度背景下的贝塞斯达系统与FRCpath、澳大利亚、日本和意大利方法的比较分析

Puja Singh, Ayush Chauhan, Surendra Padarya, Smriti Chaturvedi, Meena Singrol
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摘要

目的:世界上有许多流行的编码系统,如 Bethesda、FRCPath(英国)、澳大利亚报告系统、日本甲状腺报告系统和意大利分类系统。通过评估每种系统在印度患者群体和医疗基础设施方面的优缺点,本研究旨在找出最适合印度甲状腺细胞学准确报告和患者管理的方法:方法:在印度中部的一家三级医疗中心进行了一项回顾性队列研究,该研究通过了适当的伦理审查。共有 208 个病例符合本研究的纳入标准。一组病理学家对这些病例的临床记录和细胞学记录进行了独立分析,并按照上述所有甲状腺编码系统进行了重新分类。数据使用 Microsoft Excel 2016 进行收集和分析:约88.46%的病例为女性。内叶是最常见的部位,发病率为 80.29%。胶质性甲状腺肿是最常见的细胞学诊断。只有 11 个病例的编码在这些编码系统中存在差异。代码 1 和 2 在所有编码系统中都是相同的,而贝塞斯达代码 3 和 5 的病例则存在主要差异:贝塞斯达编码对于甲状腺 FNAC 的编码简单可靠,这一点在过去的报告中已有提及。其他编码系统也可使用,但学习曲线较长。此外,贝塞斯达编码系统被普遍使用,使报告易于理解。
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A COMPARATIVE ANALYSIS OF THYROID CYTOLOGY CLASSIFICATION SYSTEMS: BETHESDA SYSTEM VERSUS FRCPATH, AUSTRALIAN, JAPANESE, AND ITALIAN APPROACHES IN THE INDIAN CONTEXT
Objectives: There are many different popular coding systems in use across the world such as Bethesda, FRCPath (UK), the Australian reporting system, the Japanese Thyroid Reporting System, and the Italian classification system. By evaluating the strengths and weaknesses of each system concerning the Indian patient population and health-care infrastructure, this study aims to identify the most suitable approach for accurate thyroid cytology reporting and patient management in India. Methods: A retrospective cohort study was conducted at a tertiary care center in central India following due ethical clearance. A total of 208 cases met the inclusion criteria of this study. The clinical records and the cytological records of these cases were independently analyzed and reclassified by a group of pathologists into all the above-stated thyroid coding systems. Data were collected and analyzed using Microsoft Excel 2016. Results: Approximately 88.46% of the cases were women. Medial lobe was the most common site with prevalence of 80.29%. Colloid goiter is most common cytological diagnosis. Only for 11 cases, there was a difference in coding among these coding systems. Codes 1 and 2 are same in all the coding systems and the main difference identified for cases with Bethesda Codes 3 and 5. Conclusion: The Bethesda coding is simple and reliable for coding thyroid FNAC as it has been reported over the period. The other coding systems can also be used but they will have their long learning curve. Furthermore, Bethesda is being used universally making the report understandable.
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