An overview of thyroid fine-needle aspiration practice in Myanmar

Area of Science:

• Endocrinology
• Pathology
• Surgical Oncology

Background:

• Fine-needle aspiration cytology (FNAC) is a standard diagnostic procedure for thyroid nodules.
• In Myanmar, FNAC has been utilized since the early 1990s, primarily by surgeons and otorhinolaryngologists, with pathologists interpreting the results.
• While some specialists use the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), many still adhere to the British five-tier system.

Purpose of the Study:

• To evaluate the accuracy of thyroid FNAC in Myanmar through a review of local publications.
• To assess the correlation between cytologic findings and histologic diagnoses of thyroid nodules.
• To identify areas for improvement in thyroid nodule diagnosis in Myanmar.

Main Methods:

• A systematic review of local publications on thyroid FNAC accuracy and cytologic-histologic correlations was conducted.
• Ten studies published between 1991 and 2018, encompassing 540 thyroid nodules, were included in the analysis.
• Data on sensitivity, specificity, and diagnostic accuracy were extracted and synthesized.

Main Results:

• The reviewed studies demonstrated a wide range of sensitivity (64.29%–100%) and high specificity (93%–100%) for thyroid FNAC.
• Diagnostic accuracy of FNAC, based on cytologic-histologic correlations, ranged from 94% to 100%.
• The adoption of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) among pathologists in Myanmar is slow.

Conclusions:

• Thyroid FNAC exhibits high diagnostic accuracy in Myanmar, as evidenced by cytologic-histologic correlations.
• There is a need to promote the adoption of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) through targeted training and seminars.
• Further large-scale, multi-hospital studies with standardized designs are recommended to enhance the utility of thyroid FNAC in Myanmar.