Comparison between the Bethesda and the British Thyroid Association-Royal College of Physicians Systems for Reporting Thyroid Cytopathology: Experience in Two Hospitals
M Bongiovanni, WC Faquin, S Crippa. Geneva University Hospitals, Geneva, Switzerland; Harvard Medical School, Boston; Institute of Pathology, Locarno, Switzerland
Background: Thyroid FNA has proven to be one of the most effective tools for guiding the initial management of patients with thyroid nodules. The new 6-tiered Bethesda System for Thyroid FNAs sponsored by the National Cancer Institute and the 5-tiered British Thyroid Association - Royal College of Physicians thyroid FNA System offer two approaches to the problem of reporting thyroid FNA results. The efficiency of these 2 systems has particular significance for the European cytology community. In this study, we present the combined experience from our institutions for reporting thyroid FNAs using these two different systems and evaluate their efficacy based upon surgical follow up.
Design: Data on thyroid FNAs and their corresponding surgical specimens were collected at our two institutions over a two-year period. We compared the sensitivity and specificity for each of the component groups within the 2 systems where a diagnosis lead to surgery (CAT 3, 4, 5, 6 and THY 3, 4, 5 versus benign).
|Bethesda system||British system|
|Age (range)||51 (7-88)||50 (16-86)|
|Bethesda system||FNA (%)||Positive histology||Negative histology||British system||FNA (%)||Positive histology||Negative histology|
|CAT||20 (28%)||51 (72%)||THY||26 (37%)||44 (63%)|
|1||31 (10.5)||0||4||1||34 (8.8)||2||4|
|2||156 (53)||2||15||2||306 (79.3)||2||24|
|4||79 (27)||5||28||3||24 (6.2)||3||14|
|5||13 (4.4)||4||4||4||6 (1.6)||5||1|
|6||11 (3.7)||9||0||5||16 (4.1)||14||1§|