Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)

OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories. METHODS: Data from 1,479 patients who had thyroid surgery were reviewed. In total, 1,093 patients (89.6% female, mean age 52.7 (13-89) years) were included, and 386 patients were excluded. FNAB results (based on Bethesda Class) and histopathological results (benign or malignant) for coincident areas were collected. Bethesda III patients were subcategorized according to cytopathological characteristics (FLUS: follicular lesion of undetermined significance, Bethesda IIIA; AUS: atypia of undetermined significance, Bethesda IIIB). Data were correlated to obtain the malignancy rates for each Bethesda category and the newly defined subcategory. RESULTS: FNAB results for these patients were as follows: Bethesda I: 3.1%; Bethesda II: 18.6%; Bethesda III: 35.0%; Bethesda IV: 22.1%; Bethesda V: 4.1%; and Bethesda VI: 17.1%. The malignancy rates for Bethesda Class IIIB were significantly higher than those for Bethesda Class IIIA (

Efficacy in anal cancer screening through retrospective evaluation of anal cytology results related to demographic data and intercurrent viral infections

O exame de citologia anal coletado com o auxílio de escovas e realizado esfregaço convencional é uma importante ferramenta de triagem de doenças anais, em especial a infecção pelo HPV (Human Papilloma Virus), lesões pré-neoplásicas e neoplásicas. As diferenças demográficas e o câncer anal tem sido amplamente estudados em países da América do Norte, continente europeu, Oceania e Asia, geralmente em populações específicas como pacientes infectados pelo HIV ou pacientes com comportamento sexual específico (homens que fazem sexo com homens, p.ex.); e com pouco interesse em outros aspectos como gênero e outros grupos de risco. Neste contexto, pretendemos estudar retrospectivamente os resultados de citologia anal de um grande Hospital Escola de São Paulo, procurando descrever a população alvo a ser rastreada e avaliar influências de fatores demográficos, como gênero, idade no diagnóstico e fatores relacionados a infecções intercorrentes como o HPV, este detectado morfologicamente. Os resultados permitirão definir se o poder diagnóstico e de triagem da citologia anal tem o mesmo impacto em nossa regiãoThe anal cytology examination collected with cytobrush and carried out a conventional smear is an important screening tool for anal diseases, especially HPV (Human Papilloma Virus) infection, pre-neoplastic and neoplastic lesions. Demographic differences and anal cancer have been extensively studied in countries in North America, Europe, Oceania and Asia, usually in specific populations as HIV-infected patients or patients with specific sexual behavior (men who have sex with men); and with low interest in other aspects such as gender and other at-risk groups. In this context, we intend to retrospectively study the anal cytology results of a large São Paulo School Hospital, trying to describe the target population to be screened and to evaluate influences of demographic factors, such as gender, age at diagnosis and factors related to intercurrent infections such as HPV, which is detected morphologically. The results will allow us to determine whether the diagnostic and screening power of anal cytology has the same impact in our regio