Preoperative prediction of papillary thyroid carcinoma prognosis with the assistance of computerized morphometry of cytology samples obtained by fine‐needle aspiration: Preliminary report

Abstract

Cytologic features of PTC analyzed with computerized morphometry significantly correlated with recurrence. It helped to predict prognosis preoperatively and may be helpful for planning further treatment.

Using Computerized Cytomorphometry to Distinguish between Benign and Malignant Cases in Thyroid Fine‐Needle Aspiration Cytology

“…Non‐categorized lesions are reported as “atypia of undetermined significance” (AUS) or “follicular lesion of undetermined significance'' (FLUS) in TBSRTC . The AUS category is a heterogeneous group with various scenarios depending on the specimen cellularity, the presence of sample preparation artifacts, the clinical characteristics of the patients, and nuclear abnormalities suggestive of but not sufficient for malignancy . Its usefulness is controversial due to its insufficiency in serving as a guide for patient management and the conflicting application across different clinicians and institutions .…”

“…Its usefulness is controversial due to its insufficiency in serving as a guide for patient management and the conflicting application across different clinicians and institutions . Although there is an estimated risk of 5–15% for malignancy in the AUS category, a higher risk of malignancy has been revealed in some studies, and a revision for this category was subsequently recommended . Moreover, the elimination of this category from TBSRTC and the substitution of alternative categorizations has also been suggested in some studies …”

“…Mahovlic et al used both Pap and Giemsa stained slides and revealed that most of the morphometric parameters were significantly higher in May–Grunwald–Giemsa stained endometrial samples compared to Pap stained slides. In most of the studies on thyroid FNAC performed using cytology samples, slides with only one type of stain, such as hematoxylin or Pap, were used . In an older study evaluating the differences in the nuclear parameters between FN, benign nodular hyperplasia, and papillary carcinoma in thyroid cytology slides, Giemsa‐ and Pap‐stained slides were used together .…”

“…7 By the rapid and reproducible evaluation of multiple parameters, histomorphometrical image analyses allow the grading of malignant tumors and the evaluation of prognosis and therapeutic response. 8 Only a small number of studies have been performed on thyroid lesions using computerized morphometrical methods, [8][9][10][11][12][13][14][15] and some of these have been carried out using thyroidectomy specimens. 8 In the majority of the studies performed with cytology samples, slides with only one type of stain, such as hematoxylin or Papanicolaou (Pap), were used.…”

“…8 In the majority of the studies performed with cytology samples, slides with only one type of stain, such as hematoxylin or Papanicolaou (Pap), were used. 9,[11][12][13] The present study used cytology slides obtained by preoperative FNAC, stained with Pap and Giemsa and categorized according to the Bethesda system for reporting thyroid cytopathology (TBSRTC). The aim was to determine the usefulness of computerized cytomorphometrical methods, including diverse cytological nuclear parameters, for the further classification of tumors as benign or malignant, and to compare the practicability and value of Pap and Giemsa stains in thyroid FNAC by evaluating their association with the cytologic nuclear parameters.…”