Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 10, 2017; 8(2): 151-157
Published online Apr 10, 2017. doi: 10.5306/wjco.v8.i2.151
Bethesda System for Reporting Thyroid Cytopathology: A three-year study at a tertiary care referral center in Saudi Arabia
Mohamed Abdulaziz Al Dawish, Asirvatham Alwin Robert, Aljuboury Muna, Alkharashi Eyad, Abdullah Al Ghamdi, Khalid Al Hajeri, Mohammed A Thabet, Rim Braham
Mohamed Abdulaziz Al Dawish, Asirvatham Alwin Robert, Department of Endocrinology, Prince Sultan Military Medical City, Riyadh 11342, Saudi Arabia
Aljuboury Muna, Department of Pathology, Prince Sultan Military Medical City, Riyadh 11342, Saudi Arabia
Alkharashi Eyad, Abdullah Al Ghamdi, Khalid Al Hajeri, Department of General Surgery, Prince Sultan Military Medical City, Riyadh 11342, Saudi Arabia
Mohammed A Thabet, Department of Radiology, Prince Sultan Military Medical City, Riyadh 11342, Saudi Arabia
Rim Braham, Department of Endocrinology, Henri Mondor Hospital, F-94010 Paris, France
Author contributions: All authors contributed to this work.
Institutional review board statement: The study protocol was approved by the Research and Ethics committee of Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Informed consent statement: Not applicable.
Conflict-of-interest statement: Authors have no conflict of interests and the work was not supported or funded by any drug company.
Data sharing statement: No data sharing as this manuscript and the data were not published elsewhere.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Mohamed Abdulaziz Al Dawish, MD, Department of Endocrinology, Prince Sultan Military Medical City, Alrabwa, P.O. Box 261370, Riyadh 11342, Saudi Arabia. maldawish@psmmc.med.sa
Telephone: +966-50-2048321
Received: November 3, 2016
Peer-review started: November 6, 2016
First decision: November 30, 2016
Revised: December 8, 2016
Accepted: December 27, 2016
Article in press: December 29, 2016
Published online: April 10, 2017
Abstract
AIM

To stratify the malignancy risks in thyroid nodules in a tertiary care referral center using the Bethesda system.

METHODS

From January, 2012 to December, 2014, a retrospective analysis was performed among 1188 patients (15-90 years) who had 1433 thyroid nodules and fine-needle aspiration at Prince Sultan Military Medical City, Saudi Arabia. All thyroid cyto-pathological slides and ultra sound reports were reviewed and classified according to the Bethesda System for Reporting Thyroid Cytopathology. Age, gender, cytological features and histological types of the thyroid cancer were collected from patients’ medical chart and cytopathology reports.

RESULTS

There were 124 total cases of malignancy on resection, giving an overall surgical yield malignancy of 33.6%. Majority of the thyroid cancer nodules (n = 57, 46%) in Bethesda VI category followed by Bethesda IV (n = 25, 20.2%). Almost 40% of the cancer nodules in 31-45 age group in both sex. Papillary thyroid carcinoma (PTC) was the most common form of thyroid cancer among the study population (111, 89.6%) followed by 8.9% of follicular thyroid carcinoma (FTC), 0.8% of medullary carcinoma and 0.8% of anaplastic carcinoma. Among the Bethesda IV category 68% thyroid nodules were PTC and 32% FTC.

CONCLUSION

The malignancy values reported in our research were constant and comparable with the results of other published data with respect to the risk of malignancy. Patients with follicular neoplasm/suspicious for follicular neoplasm and suspicious of malignancy categories, total thyroidectomy is indicted because of the substantial risk of malignancy.

Keywords: Bethesda, Total thyroidectomy, Thyroid nodules, Risk of malignancy, Fine needle aspiration

Core tip: The purpose of this study was to stratify the malignancy risks in thyroid nodules in a tertiary care referral center using the Bethesda system. The study found that there were 124 total cases of malignancy on resection, giving an overall surgical yield malignancy of 33.6%. Majority of the thyroid cancer nodules in Bethesda VI category followed by Bethesda IV. Almost 40% of the cancer nodules in 31-45 age group in both sex. Papillary Thyroid Carcinoma was the most common form of thyroid cancer among the study population followed by follicular thyroid carcinoma, medullary carcinoma and anaplastic carcinoma.