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
Authors
Fischer, Andrew HClayton, Amy C.
Bentz, Joel S.
Wasserman, Patricia G.
Henry, Michael R.
Souers, Rhona J.
Moriarty, Ann T.
UMass Chan Affiliations
Department of PathologyDocument Type
Journal ArticlePublication Date
2013-01-01Keywords
Biopsy, Fine-NeedleCarcinoma, Papillary
Diagnostic Errors
Goiter
Humans
Pathology, Surgical
Societies, Medical
Thyroid Diseases
Thyroid Gland
Thyroid Neoplasms
United States
Diagnosis
Pathology
Metadata
Show full item recordAbstract
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 Hurthle 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.Source
Andrew H. Fischer, Amy C. Clayton, Joel S. Bentz, Patricia G. Wasserman, Michael R. Henry, Rhona J. Souers, and Ann T. Moriarty (2013) 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. Archives of Pathology & Laboratory Medicine: January 2013, Vol. 137, No. 1, pp. 26-31. doi: 10.5858/arpa.2012-0009-CP. Link to article on publisher's siteDOI
10.5858/arpa.2012-0009-CPPermanent Link to this Item
http://hdl.handle.net/20.500.14038/29916PubMed ID
23276172Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.5858/arpa.2012-0009-CP