Endocrine Abstracts

Aim: To assess the accuracy of the TBSRTC in verification of thyroid carcinoma in the region of Moscow county.

Material and methods: A retrospective study of data from electronic medical notes of 1,675 patients who underwent fine needle aspiration biopsy of nodular thyroid glands in 2016. The cytological conclusion was evaluated in accordance with the TBSRTC. In cases of surgical treatment (thyroidectomy or hemithyroidectomy) the cytological diagnosis was confirmed by morphology studies and then grouped into the following categories: malignant and benign. Specificity, sensitivity, PPV and NPV were calculated with Microsoft Excel 2016.

Results: The frequency distribution of Bethesda categories in the cohort studied was: 112 (6.7%) for category I, 1432 (85.5%) for II, 7 (0.42%) for III, 90 (5.4%) for IV, 11 (0.7%) for V, 23 (1.3%) for category VI. Surgical treatment was performed in 115 cases (6.9%) in patients: 1 from 112 pts in category I; in 36 from 1432 pts in category II; in 3 of 7 pts in category III; in 46 from 90 pts in category IV; in all 11 pts in category V; in 18 from 23 pts in category VI. Thyroid carcinoma was confirmed in 46 (40.0%) cases of surgical treatment group: 0 pts in category I, in 3 (8.3%) pts in category II, in 2 (66.7%) in category III, in 14 (30.4%) in category IV, in 9 (81.8%) pts in category V, in 18 (100%) pts in category VI. The sensitivity in detecting malignant neoplasms for categories IV+V+VI was 89.1% (95% CI 77–95.3%); specificity for category IV was 46.3% (35.1–58%); for category V 97.1% (90–99.2%); for category VI 100% (94.7–100%). PPV for category IV was 30.4 (19.1–44.8%); for category V 81.8 (52.3–94.9%); for category VI 100% (82.4–100%). NPV for category IV was 53.6 (42–65%); for category V 64.4 (54.9–73%); for category VI 71.1 (61.5–79.2%).

Conclusion: The highest PPV and NPV were noted in category VI, the lowest value was found in category IV. Sensitivity for categories IV+V+VI was high and majority of malignant cases were identified due to cytological investigation. More studies are needed to separate malignant nodules from benigh in category IV.