贝塞斯达系统重新审视:来自印度北部的大型队列中的恶性瘤风险估计和NIFTP影响
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An R-Based Landscape Validation of a Competing Risk Model
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Shruti Singh1, Chanchal Rana2, Pooja Ramakant3
1Department of Pathology, Hind Institute of Medical Sciences, Lucknow, India.
Diagnostic cytopathology
|December 30, 2025
概括
贝塞斯达甲状腺细胞病理报告系统 (TBSRTC) 有效评估甲状腺结节恶性瘤风险. 重新分类的非侵入性卵泡甲状腺瘤与乳头状核特征 (NIFTP) 显著影响风险分层不确定的情况下.
科学领域:
- 内分泌学 在内分泌学.
- 细胞病理学 细胞病理学
- 在瘤学瘤学.
背景情况:
- 甲状腺结节在临床实践中经常遇到.
- 精细针吸收细胞学 (FNAC) 是评估恶性瘤风险的主要诊断工具.
- 贝塞斯达甲状腺细胞病理报告系统 (TBSRTC) 标准化了甲状腺结节的解释和管理.
研究的目的:
- 评估甲状腺结节中TBSRTC类别的分布.
- 为了确定每个TBSRTC类别的瘤风险 (RON) 和恶性瘤风险 (ROM).
- 评估重新分类的非侵入性毛囊性甲状腺新生体与乳头状核特征 (NIFTP) 对ROM的影响.
主要方法:
- 在2016-2024年期间对2578例甲状腺FNAC病例进行了回顾性审查.
- 使用TBSRTC (2017年和2023年版本) 的细胞学诊断的分类.
- 在1043例 (40.5%) 的组织病理相关性计算RON和ROM,在NIFTP排除之前和之后评估ROM.
主要成果:
- 良性和恶性类别占大多数病例 (分别为73.2%和7.2%).
- ROM在TBSRTC类别中呈现逐步增加,范围从3.7%-9.9% (良性) 到58.6%-100% (恶性).
- 除了NIFTP,在不确定的类别中显著减少了ROM:AUS (43.2%至31.8%),FN (40.2%至28.4%) 和SM (52.4%至42.9%).
结论:
- TBSRTC为甲状腺结节提供了可靠的风险分层.
- 对NIFTP的重新分类大大改变了对不确定的类别的ROM.
- 精确的细胞-组织学相关性和区域验证对于优化甲状腺结节管理至关重要.
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