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Performance Differences Between Conventional Smears and Liquid-Based Preparations of Thyroid Fine-Needle Aspiration Samples: Analysis of 47 076 Responses in the College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytology.
MedLine Citation:
PMID:  23276172     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context.-Controversy exists about whether thyroid fine-needle aspirates (FNAs) should be processed with conventional smears or liquid-based preparations (LBPs). Objective.-To compare the performance of conventional smears to LBPs for thyroid FNA slides circulated in the College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytology. Design.-Participant responses for thyroid FNA slides were compared with the reference diagnosis at the level of 3 general diagnostic categories: negative, suspicious (which included only follicular and Hürthle cell neoplasm), and malignant. For specific reference diagnoses of benign/goiter and papillary thyroid carcinoma, the participants' specific diagnoses were analyzed and poorly performing slides were rereviewed. Results.-The 47 076 thyroid FNA slide responses, between 2001 and 2009, included 44 478 responses (94%) for conventional smears and 2598 responses (6%) for LBPs. For the general reference category negative, participant responses were discrepant in 14.9% of conventional smears compared with 5.9% for LBPs (P < .001). The specific reference diagnosis of benign/goiter was misdiagnosed as a follicular neoplasm in 7.8% of conventional smears, compared with 1.3% of LBP. For the general reference category of malignant, participant responses were discrepant in 7.3% of conventional smears compared with 14.7% of LBPs (P < .001). The specific reference diagnosis of papillary thyroid carcinoma was misdiagnosed as benign/goiter in 7.2% of LBPs, compared with 4.8% of conventional smears (p <.001). Conclusions.-LBPs performed worse than conventional smears for cases with a reference diagnosis of papillary thyroid carcinoma. However, LBPs performed better than conventional smears for cases with a benign reference diagnosis. Specific features in thyroid FNAs that may improve the diagnostic accuracy of LBPs and conventional smears are described.
Authors:
Andrew H Fischer; Amy C Clayton; Joel S Bentz; Patricia G Wasserman; Michael R Henry; Rhona J Souers; Ann T Moriarty
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  137     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  26-31     Citation Subset:  -    
Affiliation:
From the Department of Cytopathology, University of Massachusetts, Worcester (Dr Fischer); the Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota (Drs Clayton and Henry); the Department of Pathology, Laboratory Medicine Consultants, Ltd, Las Vegas, Nevada (Dr Bentz); the Department of Anatomic Pathology Services, North Shore-Long Island Jewish Health System, New Hyde Park, New York (Dr Wasserman); the Department of Statistics and Biostatistics, College of American Pathologists, Northfield, Illinois (Ms Souers); and the Department of Pathology, AmeriPath Indiana, Indianapolis, Indiana (Dr Moriarty).
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