CORRELATION BETWEEN PREOPERATIVE FINE NEEDLE BIOPSY (FNA) AND PATHOLOGY REPORT FOR THYROID NODULES: A PROSPECT STUDY

Introduction: The Bethesda system for thyroid cytology was created in 2007, to categorize, evaluate and estimate the risk of thyroid cancer. Furthermore, the estimated cancer risk, according to recent literature, is 1 to 4% for Bethesda I, 0 to 3% for Bethesda II, 5 to 15% for Bethesda III, 15 to 30% for Bethesda IV, 60 to 70% for Bethesda V, and 97 to 99% cancer risk for nodules classified as Bethesda VI. However, we observe higher rates of carcinoma in patients classified as Bethesda III and IV. Objective: To correlate the results of cytopathological findings with histological reports. Methods: Prospective study at Instituto de Cancer Dr Arnaldo from August 2014 to January 2019, with 604 patients enrolled. Inclusion criteria for surgical treatment included: patients classified as Bethesda III, IV, V or VI, or thyroid nodules larger than 3 cm, regardless of the FNA results. Fisher's test and Pearson's chi squared test were performed to assess the dependence between the variables and Spearman's test to assess the correlation between the cytological and pathological reports. Results: In our cohort, 360 patients were diagnosed as papillary carcinoma. The correlation between FNA and histopathological findings was 0% for Bethesda I, 20.6% for classification II, 34.7% for Bethesda III, 39.8% for classification IV, 71.4% for classification V and 89, 3% for Bethesda VI (p <0.01). Conclusions: The risk of malignancy in cases with FNA Bethesda I, II, V and VI is similar to recent literature. However, we observed a higher malignancy rate in cases with Bethesda III and IV cytology.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019