Inter- and Intra-observer Reproducibility of Thyroid Fine Needle Aspiration Cytology: An investigation of Bethesda 2023 Using Immunohistochemical BRAFV600E Antibody.

Background: The Bethesda System for Reporting Thyroid Cytology (TBSRTC) recommended for the interpretation of needle aspiration cytology of the thyroid, is the most widely used worldwide. Studies have shown that the disagreement between observers, especially in the Bethesda III and IV diagnostic cat...

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Publicado en:Journal of Cytology Vol. 41; no. 4; pp. 221 - 229
Autores principales: Bahattin, Erdogan, Emine, Dündar, Kısmet Çivi, Çetin, Fatih, Yılmaz
Formato: pictorial research tables/charts Journal Article
Publicado: Wolters Kluwer India Pvt Ltd Oct-Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct-Dec2024
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      pub: Wolters Kluwer India Pvt Ltd
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        10.4103/joc.joc_26_24
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        atl: Inter- and Intra-observer Reproducibility of Thyroid Fine Needle Aspiration Cytology: An investigation of Bethesda 2023 Using Immunohistochemical BRAFV600E Antibody.
      aug:
        au:
          Bahattin, Erdogan
          Emine, Dündar
          Kısmet Çivi, Çetin
          Fatih, Yılmaz
        affil: Department of Pathology, Eskisehir City Hospital, Eskisehir, Turkey
      sug:
        subj:
          Thyroid Gland Pathology
          Thyroid Diseases Diagnosis
          Biopsy, Needle
          Cytology Methods
          Cytodiagnosis
          Reproducibility of Results
          Observer Bias
          Immunohistochemistry
          Human
          Aspiration Microbiology
          Thyroid Nodule Pathology
          Thyroid Neoplasms Diagnosis
          Diagnostic Errors Prevention and Control
          Molecular Diagnostic Techniques
          Antibodies, Monoclonal
          Descriptive Statistics
          kappa Statistic
          Sensitivity and Specificity
          Interrater Reliability
      ab: Background: The Bethesda System for Reporting Thyroid Cytology (TBSRTC) recommended for the interpretation of needle aspiration cytology of the thyroid, is the most widely used worldwide. Studies have shown that the disagreement between observers, especially in the Bethesda III and IV diagnostic categories, is not insignificant at 10%–40%. In the TBSRTC 2023 version, some definitions were removed and simplified, and molecular pathology was proposed as a complement to cytopathology. The current availability of molecular tests is limited because they can be performed in a few centers and are expensive. Therefore, our study investigated intra- and inter-observer agreement according to TBSRTC 2023 using only immunohistochemically BRAFV600E antibodies. Materials and Methods: The study included 173 cases with aspiration cytology evaluated between 2019 and 2022. The immunohistochemical procedure applied BRAFV600E (RM8) monoclonal antibody to cell block sections. All slides were assessed and categorized by three different observers. Data were interpreted using Cohen's kappa and Fleiss's kappa test in the Statistical Package for Social Sciences Windows 2021 program. Results: For the applied RM8 antibody, sensitivity was 64.71% and specificity was 87.27%. In terms of diagnostic categories, inter-observer agreement was good for Bethesda II (K = 0.606) and moderate for Bethesda III (K = 0.429), Bethesda IV (K = 0.523), Bethesda V (K = 0,464), and Bethesda VI (K = 0.544), respectively. Conclusion: In conclusion, the study reveals that the 2023 version of TBSRTC provides improvement, especially in the categories of uncertain diagnosis, but is still insufficient to improve cytological diagnostic accuracy, at which point molecular analyses become even more important.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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