A Comprehensive Approach to the Thyroid Bethesda Category III (AUS) in the Transition Zone Between 2nd Edition and 3rd Edition of The Bethesda System for Reporting Thyroid Cytopathology: Subcategorization, Nuclear Scoring, and More

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dc.contributor.authorBagis, Merve
dc.contributor.authorCan, Nuray
dc.contributor.authorSut, Necdet
dc.contributor.authorTastekin, Ebru
dc.contributor.authorErdogan, Ezgi Genc
dc.contributor.authorBulbul, Buket Yilmaz
dc.contributor.authorSezer, Yavuz Atakan
dc.date.accessioned2024-06-12T10:52:52Z
dc.date.available2024-06-12T10:52:52Z
dc.date.issued2024
dc.departmentTrakya Üniversitesien_US
dc.description.abstractSignificant interobserver variabilities exist for Bethesda category III: atypia of undetermined significance (AUS) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Thus, subcategorization of AUS including AUS nuclear and AUS other is proposed in the recent 3rd edition of TBSRTC. This study investigated the impact of the nuclear features/architectural features/nuclear score (NS) (3-tiered)/subcategories and subgroups on risk of malignancy (ROM) in thyroid fine-needle aspirations (FNA). 6940 FNAs were evaluated. 1224 (17.6%) cases diagnosed as AUS were reviewed, and 240 patients (initial FNAs of 260 nodules and 240 thyroidectomies) were included. Subcategories and subgroups were defined according to TBSRTC 2nd and 3rd editions. Histological diagnostic groups included nonneoplastic disease, benign neoplasm, low-risk neoplasm, and malignant neoplasm. Overall, ROM was 30.7%. ROM was significantly higher in FNAs with nuclear overlapping (35.5%), nuclear molding (56.9%), irregular contours (42.1%), nuclear grooves (74.1%), chromatin clearing (49.4%), and chromatin margination (57.7%), and these features were independent significant predictors for malignancy. FNAs with NS3 had significantly higher ROM (64.2%). Three-dimensional groups were significantly more frequent in malignant neoplasms (35.7%). ROM was significantly higher in AUS-nuclear subcategory (48.2%) and in AUS-nuclear and architectural subcategory (38.3%). The highest ROM was detected in AUS-nuclear1 subgroup (65.2%). ROM was significantly higher in the group including AUS-nuclear and AUS-nuclear and architectural subcategories, namely high-risk group than the group including other subcategories, namely low-risk group (42.0%vs 13.9%). In conclusion, subcategorization may not be the end point, and nuclear scoring and evaluation of architectural patterns according to strict criteria may provide data for remodeling of TBSRTC categories.en_US
dc.description.sponsorshipTrakya Universityen_US
dc.description.sponsorshipNo Statement Availableen_US
dc.identifier.doi10.1007/s12022-024-09797-1
dc.identifier.endpage76en_US
dc.identifier.issn1046-3976
dc.identifier.issn1559-0097
dc.identifier.issue1en_US
dc.identifier.pmid38280141en_US
dc.identifier.scopus2-s2.0-85183389578en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage51en_US
dc.identifier.urihttps://doi.org/10.1007/s12022-024-09797-1
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18866
dc.identifier.volume35en_US
dc.identifier.wosWOS:001148622000002en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherHumana Press Incen_US
dc.relation.ispartofEndocrine Pathologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAtypia Of Undetermined Significanceen_US
dc.subjectRisk Of Malignancyen_US
dc.subjectSubcategorizationen_US
dc.subjectNuclear Atypiaen_US
dc.subjectNuclear Scoreen_US
dc.subjectThe Bethesda Systemen_US
dc.subjectUndetermined Significance/Follicular Lesionen_US
dc.subjectNeedle-Aspiration-Cytologyen_US
dc.subjectAtypical Follicular Cellsen_US
dc.subjectArchitectural Atypiaen_US
dc.subjectRisken_US
dc.subjectMalignancyen_US
dc.subjectNodulesen_US
dc.subjectSubclassificationen_US
dc.subjectFeaturesen_US
dc.subjectExperienceen_US
dc.titleA Comprehensive Approach to the Thyroid Bethesda Category III (AUS) in the Transition Zone Between 2nd Edition and 3rd Edition of The Bethesda System for Reporting Thyroid Cytopathology: Subcategorization, Nuclear Scoring, and Moreen_US
dc.typeArticleen_US

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