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Impact of the Reclassification of “Noninvasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma” to “Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features” on the Bethesda System for Reporting Thyroid Cytopathology

2017; Oxford University Press; Volume: 149; Issue: 1 Linguagem: Inglês

10.1093/ajcp/aqx136

1943-7722

Ryan P. Lau, John Paulsen, Tamar Brandler, Liu C, Aylin Simsir, Fang Zhou,

Radiomics and Machine Learning in Medical Imaging

Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (NEFVPTC) was recently reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Excluding "carcinoma" from the new terminology shifted NIFTP out of the malignant category and altered Bethesda System for Reporting Thyroid Cytopathology (BSRTC) rates of malignancy (ROMs) on thyroid fine-needle aspiration (FNA). Because of potential effects on management guidelines, we examined our ROM data.In total, 750 thyroid FNAs with surgical resections from January 2013 to June 2016 were reviewed (including 87 NIFTPs). ROM was recorded for each BSRTC category: classifying NEFVPTC/NIFTP as "malignant" and reclassifying NEFVPTC/NIFTP as "nonmalignant."ROM changes were as follows: nondiagnostic (ND), no change; benign, 5.5% to 2.5%; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 42.3% to 22.3%; follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 48.7% to 17.9%; suspicious for malignancy (SFM), 93.6% to 61.7%; and positive for malignancy, 100% to 97%.Decreased ROM was seen in most BSRTC categories, most significantly in AUS/FLUS, FN/SFN, and SFM categories.