Score system for cytological evaluation of fine-needle aspiration specimens to predict the diagnosis of papillary thyroid carcinomas

Author(s)

Borges, Felipe Abrantkoski ; Camilo, Deolino Joao ; Carlos de Almeida, Eduardo Henrique ; Quirino Louzada, Mario Jefferson ; Caldeira Xavier, Jose Candido

• Document type: Journal article
• Source: ANNALS OF DIAGNOSTIC PATHOLOGY; v. 64, p. 6-pg., 2023-02-21.

Abstract

Introduction: According to the World Health Organization's classification of endocrine tumors, papillary thyroid carcinoma (PTC) accounts for almost 90 % of malignant thyroid neoplasms. This study aimed to create a point system based on cytomorphological criteria for evaluating FNA products from thyroid nodules to predict the risk of papillary thyroid carcinomas.Methods: This was an analytical observational study based on a retrospective analysis of cytological reports and surgical specimens from January 1, 2016, to December 31, 2021. Cytological slides were analyzed using the following ten variables: Nuclear Grooves; Intranuclear Pseudoinclusion; Cellularity; Colloid (Quantity); Clarified Chromatin; Overlapping nuclei; Irregular Nuclear Membrane; Multinucleated Giant Cells; Psamoma bodies; and Papillae. We categorized these variables quantitatively from zero to three points as follows: zero (absent), one (mild), two (moderate), and three (intense).Results: Cytologies of 254 (4.9 %) cases were analyzed. The cut-off point was defined in this study as 6 +/- 1 points. For the prediction of cases in benign, values < 5 points, malignant, values > 7 points and indeterminate, 5-7 points. Among the benign, there were 64 (69.5 %) cases <5 points, 17 (18.4 %) from 5 to 7 points and 11 (11.9 %) >7 points. Among the malignant ones, there were 12 (8.6 %) cases <5 points, 19 (13.6 %) from 5 to 7 points and 108 (77.6) >7 points. Conclusion: In this context, through the quantitative analysis of the ten suggested cytological variables, scored from 0 to 3, a final score > 7 is suspicious for malignancy, while a score < 5 is related to benign lesions. (AU)

• FAPESP's process: 21/00710-4 - Score system for evaluation of morphological findings in cytological smear from thyroid nodules' fine needle aspiration in order to predict thyroid Carcinomas
• Grantee: Felipe Abrantkoski Borges
• Support Opportunities: Scholarships in Brazil - Scientific Initiation