சைட்டாலஜி & ஹிஸ்டாலஜி ஜர்னல்

Better Thyroid Cytopathology Reporting System May Increase the Clinical Management and Patients Outcome

Abstract

Mulazim Hussain Bukhari, Asad Aslam Khan, Shahida Niazi, Madiha Arshad, Zahid Mahmood Akhtar and Khalid Ahmed AL-Sindi

Objective: The Bethesda System is better for Thyroid Cytopathology reporting and may increase the clinical management of Thyroid Disease. Study design: Analytical Cross sectional. Material and methods: A cross sectional study was conducted on 120 smears of thyroid swellings which were referred for fine needle aspiration to the Department of Pathology in 2011 and the Bethesda System for reporting Thyroid Cytopathology was followed in comparison to old conventional reporting system running from the last 30 years. Histopathology was used as a gold standard to compare the sensitivity of both systems. Three groups of Histopathologists were assigned three reporting systems without knowing the results of each other. The comparison was made in a meeting of 3 groups after histopathology biopsy reports were made available. Group A was assigned to report with the older system of thyroid aspiration with 7 categories, Group B reported with five classes of an older reporting system and Group C reported with the latest Bethesda Reporting System. Screening test was applied to compare the results. Results: When the results of these three systems were compared Bethesda adapted method was found to be more superior as compared to the others. Sensitivity of Group B and C is significantly high 0.051 as compared to group A (p=0.051 and 0.000)’ Sensitivity of Group C is also significantly high as compared to Group B (p=0.000). Specificity of Group B is not significant (0.326) as compared to group A. Specificity of group C is also significantly high as compared to Group A and Group B (p=0.009 and 0.002). Our findings are consistent with others who used the Bethesda Cytopathology Reporting System. Conclusions: Bethesda Cytopathology Reporting system can help with a better patient’s outcome due to proper clinical management of thyroid swellings and saves patients from unnecessary thyroid surgery.