Korean J Otorhinolaryngol-Head Neck Surg.  2010 Jul;53(7):436-440. 10.3342/kjorl-hns.2010.53.7.436.

Fine Needle Aspiration for Thyroid Nodule: Clinical Application of Bethesda Classification

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, Masan Samsung Hospital, Sunkyunkwan University School of Medicine, Masan, Korea.
  • 2Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea. entkhkwon@empal.com

Abstract

BACKGROUND AND OBJECTIVES
To evaluate the usefulness of fine needle aspiration (FNA) for thyroid nodule using the new Bethesda classification.
SUBJECTS AND METHOD
Patient cytology data were reviewed by retrospective search of thyroid FNA. Cytologic diagnoses were classified as unsatisfactory, benign/negative for malignancy, indeterminate (ID), follicular neoplasm (FN), suspicious for malignancy (SM), and positive for malignancy (PM) according to the proposing of The National Cancer Institute. We analyzed the follow-up FNA diagnoses and the cytologic-histologic correlations.
RESULTS
Of 1983 patients, 16.8% was classified as unsatisfactory, 73.6% as benign, 1.1% as ID, 0.4% as FN, 1.4% as SM, and 6.8% as PM. After the cytologic follow-up, the groups designated as unsatisafactory (80.2%) and ID (50%) mainly showed significant change in diagnosis. Two hundred fifty patients had surgical follow-up. Sensitivity, specificity, and accuracy, positive predictive values and negative predictive values for malignancy of thyroid were 87.6%, 97.2%, 91%, 98.3% and 81.2%, respectively. The cytologic-histologic diagnostic discrepancy rate was 13.6%.
CONCLUSION
FNA for thyroid nodule using the new Bethesda classification was an accurate and sensitive method for the diagnosis of thyroid nodule, and can provide useful information for the management of thyroid nodule.

Keyword

Thyroid nodule; Evaluation; Fine needle aspiration; Cytology

MeSH Terms

Biopsy, Fine-Needle
Follow-Up Studies
Humans
National Cancer Institute (U.S.)
Retrospective Studies
Sensitivity and Specificity
Thyroid Gland
Thyroid Nodule
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