Significance of Bethesda grade of scoring in comparison with post-operative histopathology in detection of cancer thyroid

Document Type : Original Research

Author

General surgery department armed forces college of medicine

Abstract

Background: The frequency of thyroid cancers has been noticeably rising over the last several decades, with a lifetime risk of around 1.2 percent of men and women becoming more probable as a result of increased screening programs and early identification of this neoplasm. Study aim: Assess the discriminant ability of Bethesda score in patients undergoing thyroid surgery in relation to postoperative histopathology for appropriate triaging of patients with thyroid nodule to appropriate decision. Material and methods: A prospective cohort research was done among 83 patients in the Department of surgery in collaboration with the Department of pathology in military Hospitals over 1 year. Patients aged 16 years or above having solitary or more thyroid nodules detected either clinically or radiologically with preoperative FNAC which categorized with Bethesda score of grading and having subsequently undergone surgery were included. Results: The correlation between TBSRTC and final postoperative Histopathology to calculate ROM for each category: TBSRTC II ROM (6.1%), TBSRTC III ROM (25.0), TBSRTC IV ROM (75.0%), TBSRTC V ROM (87.5%) and finally TBSRTC VI revealed malignancy in all cases with (100%) ROM. Sensitivity of TBSRTC was 76.0%, specificity was 94.83% with total accuracy of 89.16%. Conclusion: The Bethesda system for thyroid FNA smears contributed to more accurate cytological diagnosis and had the additional benefit of predicting the likelihood of malignancy, allowing the clinician to plan for follow-up or surgery and the extent of surgery to decrease the number of unnecessary thyroid operations for people with benign nodules.

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