Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica

Detalhes bibliográficos
Autor(a) principal: Reuter, Kassia Blauth [UNIFESP]
Data de Publicação: 2017
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5280141
http://repositorio.unifesp.br/handle/11600/50750
Resumo: Objetivos Geral: Avaliar O Comportamento Da Classificação De Bethesda Na População Brasileira, Utilizando Dados Do Ambulatório De Doenças Da Tiroide Da Universidade Federal De São Paulo - Centro De Referência De Doenças Tiroidianas No Brasil. Específico: Correlacionar Achados Citológicos E Histopatológicos Em Pacientes Submetidos À Cirurgia A Fim De Se Obter As Taxas De Malignidade Referentes A Cada Categoria Citológica De Bethesda, Comparando-As Aos Dados Reportados Na Literatura.
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spelling http://lattes.cnpq.br/3864261034300240http://lattes.cnpq.br/5447491571580985Reuter, Kassia Blauth [UNIFESP]http://lattes.cnpq.br/8884909593035829Universidade Federal de São Paulo (UNIFESP)Biscolla, Rosa Paula Mello [UNIFESP]Maciel, Rui Monteiro de Barros [UNIFESP]São Paulo2019-06-19T14:58:21Z2019-06-19T14:58:21Z2017-12-21Objetivos Geral: Avaliar O Comportamento Da Classificação De Bethesda Na População Brasileira, Utilizando Dados Do Ambulatório De Doenças Da Tiroide Da Universidade Federal De São Paulo - Centro De Referência De Doenças Tiroidianas No Brasil. Específico: Correlacionar Achados Citológicos E Histopatológicos Em Pacientes Submetidos À Cirurgia A Fim De Se Obter As Taxas De Malignidade Referentes A Cada Categoria Citológica De Bethesda, Comparando-As Aos Dados Reportados Na Literatura.Prior to the Bethesda System for Reporting Thyroid Cytopathology, there was no standard classification and no reproducible cytological reporting applied for thyroid nodule FNA results. The Bethesda system proposed the classification of cytological results in 6 categories with the aim of standardizing the findings described by different inter-observers while also reporting malignancy rates and a different approach for each category. In this study, the incidence of each cytological category was in accordance with that proposed by the Bethesda classification and literature [3,13]: 11% nondiagnostic (2-20% by literature), 59.8% benign (55-74% by literature), and 7.1% AUS/FLUS (up to 7% by the Bethesda system and 2-18% by literature). The incidences of FN/SFN and SM, compared with the literature, were 8.5% (2-25%) and 5.1% (1-6%), respectively [3,13], but these frequencies are not reported by the Bethesda system [11,12]. The incidence of malignant FNA found in this study (8.2%) was higher than that observed in the literature (2-7%), but this can be expected, as the study was carried out in a thyroid reference center. The Bethesda system proposes that nondiagnostic nodules should be submitted to a second FNA at an appropriate interval and, in many cases (50 to 88%) [11,12], this second FNA allows them to be reclassified in a distinct category. In this study, 27/108 (25%) of nondiagnostic nodules were submitted to a second FNA and 20/27 (74%) were reclassified in a different category: 70% (14/20) benign (41.7% to 87.5% by literature), 20% (4/20) AUS/FLUS, 5% (1/20) FN/SFN and 5% (1/20) SM. Seven of 27 (25.9%) nodules remained classified as nondiagnostic after a second FNA, which is in accordance with the literature (1.2% to 47.9%) [15-18]; however, this finding is higher than that suggested by the Bethesda classification (7-10%) [11,12]. In this study, the comparatively low percentage of nondiagnostic nodules submitted to another FNA, 25% of the total, probably contributes to this result, which could be different if all nondiagnostic nodules had been submitted to a second procedure. Clinical follow-up is recommended for nodules classified as benign. If significant growth or sonographic changes are observed, another FNA should be performed [11, 12]. In this study, 12/587 (2%) benign nodules were submitted to a new FNA: 10/12 (83.3%) remained benign and 2/12 (16.6%) were reclassified as FN/SFN. In the literature, Yang et al. performed a second FNA in 11.7% of benign nodules, with 82.1% remaining benign and 9.1% reclassified in a different category [15]. According to the Bethesda system, AUS/FLUS nodules should be submitted to another FNA at an adequate interval, with the majority of them reclassified in another category [11]. In this study, 50% of AUS/FLUS nodules were reclassified as benign after a second FNA, in accordance with the literature (42.7% to 73.1%), which allows a clinical follow-up approach instead of a surgical procedure [15,21-23]. On the other hand, 9% of AUS/FLUS nodules submitted to a second FNA remained in the same category. This result was in accordance to that proposed by the Bethesda classification (approximately 20%) [11,12] and literature (3.8% to 38.5%) [15,21-23]. In this study, the malignancy rates obtained in each cytological category were in accordance with those proposed by the Bethesda classification and literature: 6% in benign nodules (0-3% by the Bethesda system and 1-10% by literature), 12% in AUS/FLUS (5-15% by the Bethesda system and literature),20.8% in FN/SFN (15-30% by both the Bethesda system and literature), 72.5% in SM (60-75% by both the Bethesda system and literature) and 97.3% in the malignant category (97-99% by both the Bethesda system and literature) [3,11-18,23]. The malignancy rate obtained in the nondiagnostic category was 25.7%, with 67% of the cases being microcarcinomas. This result was in accordance to previous studies published in the literature (10% to 35%) [13-16] but was higher than that proposed by Bethesda system (1 to 4%) [11,12]. One possible reason for this finding is that the majority of nondiagnostic nodules were submitted to surgery before performing a second FNA, due to the presence of other suspicious nodules in the gland or a nodule size greater than 3 cm. If those nodules had been submitted to a second FNA, they probably would have been reclassified in the suspicious category. In conclusion, this study found that the Bethesda system can be applied to the Brazilian population since the frequency of each category and malignancy rates were similar to those described by the classification. However, a higher malignancy rate was observed in a nondiagnostic cytological category. In the presence of a multinodular goiter with a nondiagnostic result and another nodule greater than 3.0 cm or with another suspicious cytological nodule, the occurrence of multifocal tumors should be carefully evaluated.Dados abertos - Sucupira - Teses e dissertações (2017)46 f.https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5280141http://repositorio.unifesp.br/handle/11600/50750porUniversidade Federal de São Paulo (UNIFESP)Nodulo tiroidianoClassificação de BethesdaCitologia tiroidianaPunçao aspirativa agulha finaRisco de malignidadeThyroid noduleBethesda rankingThyroid cytologyFine needle aspiration punctureRisk of malignancyAvaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológicaBethesda classification and cytohistological correlation of thyroid nodules in a Brazilian thyroid disease centerinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPEscola Paulista de MedicinaMedicina (Endocrinologia Clínica)TiróideTiróide: Fisiologia e FisiopatologiaORIGINALKASSIA BLAUTH REUTER PDF A.pdfKASSIA BLAUTH REUTER PDF A.pdfDissertação de mestradoapplication/pdf604178https://repositorio.unifesp.br/bitstreams/1701a5ef-fb9c-48b0-b549-dde1c3755936/download96bce91d20da79e132762e1c62634cecMD5111600/507502024-02-01 14:52:55.996oai:repositorio.unifesp.br/:11600/50750https://repositorio.unifesp.brRepositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652024-02-01T14:52:55Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.pt_BR.fl_str_mv Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
dc.title.alternative.en.fl_str_mv Bethesda classification and cytohistological correlation of thyroid nodules in a Brazilian thyroid disease center
title Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
spellingShingle Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
Reuter, Kassia Blauth [UNIFESP]
Nodulo tiroidiano
Classificação de Bethesda
Citologia tiroidiana
Punçao aspirativa agulha fina
Risco de malignidade
Thyroid nodule
Bethesda ranking
Thyroid cytology
Fine needle aspiration puncture
Risk of malignancy
title_short Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
title_full Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
title_fullStr Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
title_full_unstemmed Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
title_sort Avaliação retrospectiva de nódulos tiroidianos puncionados em serviço especializado baseada na classificação de Bethesda e correlação citohistológica
author Reuter, Kassia Blauth [UNIFESP]
author_facet Reuter, Kassia Blauth [UNIFESP]
author_role author
dc.contributor.advisor-coLattes.none.fl_str_mv http://lattes.cnpq.br/3864261034300240
dc.contributor.advisorLattes.none.fl_str_mv http://lattes.cnpq.br/5447491571580985
dc.contributor.authorLattes.none.fl_str_mv http://lattes.cnpq.br/8884909593035829
dc.contributor.institution.pt_BR.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Reuter, Kassia Blauth [UNIFESP]
dc.contributor.advisor1.fl_str_mv Biscolla, Rosa Paula Mello [UNIFESP]
dc.contributor.advisor-co1.fl_str_mv Maciel, Rui Monteiro de Barros [UNIFESP]
contributor_str_mv Biscolla, Rosa Paula Mello [UNIFESP]
Maciel, Rui Monteiro de Barros [UNIFESP]
dc.subject.por.fl_str_mv Nodulo tiroidiano
Classificação de Bethesda
Citologia tiroidiana
Punçao aspirativa agulha fina
Risco de malignidade
topic Nodulo tiroidiano
Classificação de Bethesda
Citologia tiroidiana
Punçao aspirativa agulha fina
Risco de malignidade
Thyroid nodule
Bethesda ranking
Thyroid cytology
Fine needle aspiration puncture
Risk of malignancy
dc.subject.eng.fl_str_mv Thyroid nodule
Bethesda ranking
Thyroid cytology
Fine needle aspiration puncture
Risk of malignancy
description Objetivos Geral: Avaliar O Comportamento Da Classificação De Bethesda Na População Brasileira, Utilizando Dados Do Ambulatório De Doenças Da Tiroide Da Universidade Federal De São Paulo - Centro De Referência De Doenças Tiroidianas No Brasil. Específico: Correlacionar Achados Citológicos E Histopatológicos Em Pacientes Submetidos À Cirurgia A Fim De Se Obter As Taxas De Malignidade Referentes A Cada Categoria Citológica De Bethesda, Comparando-As Aos Dados Reportados Na Literatura.
publishDate 2017
dc.date.issued.fl_str_mv 2017-12-21
dc.date.accessioned.fl_str_mv 2019-06-19T14:58:21Z
dc.date.available.fl_str_mv 2019-06-19T14:58:21Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.pt_BR.fl_str_mv https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5280141
dc.identifier.uri.fl_str_mv http://repositorio.unifesp.br/handle/11600/50750
url https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5280141
http://repositorio.unifesp.br/handle/11600/50750
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 46 f.
dc.coverage.spatial.none.fl_str_mv São Paulo
dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
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repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv
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