Rendimiento del sistema Bethesda en el diagnóstico citopatológico del nódulo tiroideo en un centro universitario (Hospital de Clínicas) de Uruguay, diez años de experiencia

Carolina Guarneri; Ulises Parada; Lucía Fernández; Roberto Taruselli; Luis Cazabán

doi:10.29193/RMU.38.2.7

Authors

Carolina Guarneri Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica “A”, Cirugía General, Asistente
Ulises Parada Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica “A”, Cirugía General, Asistente
Lucía Fernández Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica “A”, Cirugía General, Residente
Roberto Taruselli Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica “A, Cirugía General, Profesor Agregado
Luis Cazabán Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica “A”, Profesor Director

DOI:

https://doi.org/10.29193/RMU.38.2.7

Keywords:

BETHESDA SYSTEM, RISK OF MALIGNANCY, CYTOPATHOLOGICAL CORRELATION

Abstract

Introduction: the ultrasound-guided fine needle aspiration biopsy (FNAB) study is characterized by being fast, reliable, minimally invasive, and cost-effective. It reduces unnecessary surgical procedures and appropriately classifies patients with suspicious or malignant nodules for timely surgical intervention.
Objective: the objective of this study is to evaluate the cytological-pathological correlation of the Bethesda System in a university center (Hospital de Clínicas) in Uruguay.
Methodology: an observational, retrospective, descriptive study was carried out, based on the analysis of medical records of patients undergoing thyroid surgery at the Hospital de Clínicas, in the period between January 2008 and December 2018.
Results: of the initial total of 119 patients, 93 met the inclusion criteria. The age range of the sample was between 15 and 79 years. Of the total of punctured, 49.5% (46) were reported as benign and 50.5% (47) as malignant.
A sensitivity of 96% (0.96) with CI 1.0-0.90, specificity of 98% (0.97) with CI 1.0-0.93, a PPV of 98% and NPV of 96%.
The diagnostic sensitivity for categories IV, V and VI was 96% with a specificity of 100, 94 and 100% respectively.
Conclusions: the Bethesda system applied to FNA of thyroid nodules enhances diagnostic certainty and assists in the therapeutic decision. In our institution we have a good cytopathological correlation, similar to other works reported in the literature. This makes it possible to adequately predict the risk of malignancy and facilitate decision-making.

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