Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
© 2017 The Korean Society of Pathologists/The Korean Society for Cytopathology
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No. | Study | Place | Needle size and technique | Wet fixation |
Staining technique used |
Reporting system followed | |
---|---|---|---|---|---|---|---|
Wet fixation | Air-dried smears | ||||||
1 | Mandreker et al. (1995) [13] | Goa | n/s | n/s | n/s | Unsatisfactory, benign, SFM, malignant | |
2 | Sirpal (1996) [14] | Delhi | 21G | n/s | Pap, H&E | Leishman-Giemsa | Malignant, non-neoplastic, FN, Hurthle cell tumors, thyroglossal cyst, extrathyroidal, inconclusive when unsatisfactory |
3 | Handa et al. (2008) [15] | Chandigarh | 23G ± aspiration, manuala | n/s | Pap, H&E | MGG | n/s |
4 | Guhamallick et al. (2008) [16] | Kolkata | 23–24G + aspiration | n/s | Pap, H&E | Leishman-Giemsa | Unsatisfactory, non-neoplastic, indeterminate, malignant |
5 | Gupta et al. (2010) [17] | Jammu and Kashmir | n/s | Ether-95% alcohol solution | Pap | n/s | Benign, FN, SFM, malignant |
6 | Bagga and Mahajan (2010) [18] | Haryana | 23–25G, non-aspirationa | 95% Ethanol | H&E | MGG | Unsatisfactory, benign, SFM, malignant |
7 | Sengupta et al. (2011) [19] | Bihar | 22–23G + aspirationb | n/s | n/s | MGG | Colloid goiter, granulomatous thyroiditis, FA, FC, anaplastic carcinoma |
8 | Renuka et al. (2012) [20] | Andhra Pradesh | 22G ± aspiration, USG in some | 95% Methanol | Pap, H&E | MGG | TBSRTC |
9 | Sharma and Mathur (2012) [21] | Rajasthan | 23G + aspiration | Ether-95% alcohol solution | Pap, H&E | Giemsa | Unsatisfactory, non-neoplastic, FN, SFM, malignant (RCP) |
10 | Patel et al. (2013) [22] | Gujarat | 23–24G ± aspirationa | 95% Ethanol | Pap, H&E | MGG | Non-neoplastic, neoplastic, others |
11 | Mondal et al. (2013) [23] | West Bengal | n/s, USG in somea | n/s | Pap | Leishman-Giemsa | TBSTRC |
12 | Kukar et al. (2013) [24] | Punjab | n/sa | 95% isopropanol | Pap, H&E | MGG | Non-neoplastic, neoplastic |
13 | Bhasin et al. (2013) [25] | Punjab | n/s | n/s | n/s; MGG as per figures | TBSRTC | |
14 | Borgohain et al. (2014) [26] | Assam | n/s | n/s | n/s | MGG | Non-neoplastic, neoplastic |
15 | Mangshetty et al. (2014) [27] | Karnataka | 22–24G + aspiration | Alcohol | Pap | MGG | Unsatisfactory, benign, malignant |
16 | Panchal et al. (2014) [28] | Maharashtra | 22/23G + aspiration | 95% Ethanol | Pap | n/s | Unsatisfactory, benign, SFM, malignant |
17 | Pathak et al. (2014) [29] | Delhi | n/s | n/s | Pap | MGG | TBSRTC |
18 | Sukumaran et al. (2014) [30] | Kerala | n/s | 95% alcohol | Pap | n/s | TBSRTC |
19 | Arul and Masilamani (2015) [31] | Tamil Nadu | n/s | n/s | n/s, H&E as per figures | TBSRTC | |
20 | Arul et al. (2015) [32] | Tamil Nadu | n/s, USG if small lesiona | n/s | H&E | MGG | TBSRTC |
21 | Sekhar et al. (2015) [33] | Karnataka | 23–24G + aspiration | 95% Ethanol | Pap, H&E | MGG | TBSRTC |
22 | Mehra and Verma (2015) [34] | Delhi | n/s, USG in all | n/s | Pap | MGG | TBSRTC |
23 | Agrawal et al. (2015) [35] | Uttar Pradesh | 23G + aspiration | 95% Ethanol | Pap, H&E | MGG | TBSRTC |
24 | Sharma (2015) [36] | Tamil Nadu | n/s, manual | n/s | n/s | Unsatisfactory, benign, follicular pattern lesions, suspicious (includes atypical), malignant | |
25 | Thakkar et al. (2015) [37] | Gujarat | 22/24G + aspirationa | n/s | H&E | MGG | TBSRTC |
26 | Garg et al. (2015) [38] | Gujarat | 23–24G + aspirationa | n/s | n/s | TBSRTC | |
27 | Kathirvel (2015) [39] | Tamil Nadu | 25–27G | 100% Isopropanol | H&E | TBSRTC | |
28 | Alagarsamy et al. (2015) [40] | Tamil Nadu | 23G ± aspiration | 100% Isopropanol | H&E | n/s | Colloid goiter, adenoma, carcinoma, others |
29 | Mamatha et al. (2015) [42] | Telangana | n/s | n/s | n/s | n/s | Unsatisfactory, colloid cyst/goiter, follicular lesions/ neoplasm, indeterminate, SFM, malignant as well as TBSRTC |
30 | Gupta et al. (2015) [43] | Uttar Pradesh | n/s | n/s | Pap | Diff-Quick | Histopathological equivalents as well as TBSRTC |
31 | Hathila et al. (2016) [41] | Gujarat | 23G, non-aspiration | 95% Ethanol | Pap, H&E | MGG | Benign, malignant |
32 | Shankar et al. (2016) [44] | Tamil Nadu | n/s + aspiration | n/s | Pap | n/s | TBSRTC |
33 | Prathima et al. (2016) [45] | Karnataka | n/s, USG in some | Alcohol | Pap, H&E | Giemsa | TBSRTC |
34 | Mehrotra et al. (2016) [46] | Karnataka | n/s ± aspiration, USG in some | 95% Ethanol | H&E | MGG | TBSRTC |
35 | Tagore et al. (2016) [47] | Karnataka | 22G + aspiration | Alcohol | Pap | MGG | TBSRTC |
36 | Kalita and Das (2016) [48] | Assam | 23G ± aspiration | n/s | n/s | MGG | TBSRTC |
37 | Bhartiya et al. (2016) [49] | Bihar | 23–24G + aspiration, USG in somea | Wet fixed | Pap | Leishman-Giemsa | TBSRTC |
38 | Kulkarni et al. (2016) [50] | Madhya Pradesh | n/s | n/s | Pap | n/s | TBSRTC |
39 | Lohiya et al. (2016) [51] | Rajasthan | 23/24G | n/s | n/s | MGG | TBSRTC |
40 | Kasliwal et al. (2016) [52] | 24–26G + aspiration | 95% Ethanol | H&E | MGG | TBSRTC | |
41 | Khatib et al. (2016) [53] | Maharashtra | n/s, USG if unsatisfactory | n/s | Pap | Giemsa | TBSRTC |
42 | Pantola et al. (2016) [54] | Tamil Nadu | 23G | 95% Alcohol | Pap, H&E | MGG | TBSRTC |
43 | Babu et al. (2016) [55] | Tamil Nadu | 23G | Ether-95% alcohol solution | Pap | n/s | Unsatisfactory, benign, malignant |
44 | Solanki et al. (2016) [56] | Rajasthan | n/s | n/s | H&E | MGG | TBSRTC |
45 | Aramani and Gururajaprasad (2017) [57] | Karnataka | 24–25G + aspiration | 95% Ethanol | Pap, H&E | MGG | Benign, malignant |
46 | Sunder and Khan (2017) [58],b | Telangana | 23/25/26G + aspiration | 95% Ethyl alcohol or isopropanol | Pap, H&E | MGG | Benign, malignant |
47 | Garg et al. (2017) [59] | Maharashtra | n/s ± aspiration, USG in all | n/s | Pap | MGG | TBSRTC |
48 | Kannan et al. (2017) [60] | Karnataka | n/sa,b | n/s | n/s | n/s | TBSRTC |
49 | Mahajan et al. (2017) [61] | Chandigarh | n/s | n/s | n/s | n/s | TBSRTC |
50 | Chandra et al. (2017) [62] | Uttarakhand | 26–28G | Alcohol | Pap, H&E | MGG | TBSRTC |
51 | Laishram et al. (2017) [63] | Manipur | n/s | n/s | n/s | MGG | TBSRTC |
FNA, fine needle aspiration; n/s, not specified; SFM, suspicious for malignancy; Pap, Papanicolaou stain; H&E, hematoxylin and eosin; FN, follicular neoplasm; MGG, May-Grünwald-Giemsa; FA, follicular adenoma; FC, follicular carcinoma; USG, ultrasound-guided aspirate; TBSRTC, The Bethesda System for Reporting Thyroid Cytopathology; RCP, Royal College of Pathologists guidelines.
aFNA performed by cytopathologist;
bFNA performed by clinician.
No. | Study | Thyroid FNA (operated nodules) |
Distribution of the Bethesda categories and corresponding risk of malignancy (%) |
|||||
---|---|---|---|---|---|---|---|---|
I | II | III | IV | V | VI | |||
1 | Mandreker et al. (1995) [13] | 1,992 (238) | 12.7 | 78.2 (5.5) | - | - | 7.6 (26.3) | 1.5 (91.7) |
2 | Sirpal (1996) [14] | 1,114a (128) | 0.6b (0) | 97.1 (0) | - | 1 (11.1) | - | 1.3 (100) |
3 | Handa et al. (2008) [15] | 434 (66) | 5.1 | 87.8 (1.9) | - | 3.2 (0) | - | 3.9 (100) |
4 | Guhamallick et al. (2008) [16] | 288 (75) | 13.5 | 68.4 (3.1) | - | 9.4 (30) | - | 8.7 (95.6) |
5 | Gupta et al. (2010) [17] | 75 (75) | - | 60 (6.7) | - | 24 (16.7) | 4 (0) | 12 (100) |
6 | Bagga and Mahajan (2010) [18] | 252 (32) | 1.6 | 90.5 | - | - | 6.7 | 1.2 |
7 | Renuka et al. (2012) [20] | 564 | 17 | 70.5 | 1.9 | 4.2 | 2.6 | 3.5 |
8 | Sharma and Mathur (2012) [21] | 94 (76) | 2.1 | 53.2 (0) | - | 35.1 (10) | 2.1 (100) | 7.4 (100) |
9 | Mondal et al. (2013) [23] | 1,020 (323) | 1.2 (0) | 87.5 (4.5) | 1 (20) | 4.2 (30.6) | 1.4 (75) | 4.7 (97.8) |
10 | Bhasin et al. (2013) [25] | 80 | 1.2 | 61.2 | 10 | 20 | 3.8 | 3.8 |
11 | Panchal et al. (2014) [28] | 300 (36) | - | 98.7 | - | - | 0.3 | 1 |
12 | Pathak et al. (2014) [29] | 454 | 25.7 | 59 | 6 | 4 | 1.8 | 3.5 |
13 | Sukumaran et al. (2014) [30] | 248 (248) | 6 (6.7) | 12.5 (12.9) | 4.4 (54.6) | 13.3 (87.9) | 4 (100) | 59.7 (100) |
14 | Arul and Masilamani (2015) [31] | 483 (209) | 5 (8.3) | 44.5 (1.1) | 2.9 (0) | 21.5 (11.5) | 15.3 (96.9) | 10.8 (100) |
15 | Arul et al. (2015) [32] | 603 (392) | 2.7 (0) | 65.2 (1.2) | 10 (24.4) | 10.6 (28.9) | 5.3 (70.8) | 6.3 (100) |
16 | Sekhar et al. (2015) [33] | 150 (64) | 2.6 (0) | 76.6 (0) | 0.7 | 12.7 (5.9) | 2.7 (100) | 4.7 (66.7) |
17 | Mehra and Verma (2015) [34] | 225 (40) | 7.2 (0) | 80 (13) | 4.9 (100)c | 2.2 (25) | 3.5 (50) | 2.2 (100) |
18 | Agrawal et al. (2015) [35] | 281 (134) | 2.5 (0) | 87.9 (1.8) | 3.9 | 2.5 (18.2) | 1.8 (80) | 1.4 (100) |
19 | Sharma (2015) [36] | 724 (724) | - | 87.7 (1.3) | - | - | 2.9 (52.4) | 9.4 (97.1) |
20 | Thakkar et al. (2015) [37] | 134 (24) | 4.5 (0) | 85.8 (0) | 0.7 | 7.5 (33.3) | 0.7 | 0.7 |
21 | Garg et al. (2015) [38] | 100 (60) | 6 (20) | 78 (0) | 4 (25) | 5 (20) | 3 (66.7) | 4 (100) |
22 | Kathirvel (2015) [39] | 59 | 15.3 | 16.9 | 15.3 | 16.9 | 15.3 | 20.3 |
23 | Mamatha et al. (2015) [42] | 240 (214) | 10.8 | 59.2 (0) | 4.2 (50) | 15 (6.7) | 4.2 (60) | 6.6 (100) |
24 | Gupta et al. (2015) [43] | 300 | 11 | 78 | 2 | 3 | 1 | 5 |
25 | Shankar et al. (2016) [44] | 402 (92) | 10.7 (0) | 81.6 (1.6) | 1.2 (0) | 1.7 (28.6) | 2 (71.4) | 2.7 (80) |
26 | Prathima et al. (2016) [45] | 178 (60) | 11.7 (33.3) | 77.5 (7.1) | 1.1 (50) | 3.9 (25) | 2.2 (66.7) | 3.3 (100) |
27 | Mehrotra et al. (2016) [46] | 175 (34) | 4.6 | 68.6 (0) | 5.7 | 17.1 (0) | 1.1c (0) | 2.9c (100) |
28 | Tagore et al. (2016) [47] | 100 | 3 | 81 | 0 | 9 | 3 | 4 |
29 | Kalita and Das (2016) [48] | 664 | 12 | 72.3 | 1.8 | 4.8 | 1.5 | 7.5 |
30 | Bhartiya et al. (2016) [49] | 238 (105) | 5.9 | 84 (2) | 1.3 | 2.9 (0) | 2.5 | 3.4 (100) |
31 | Kulkarni et al. (2016) [50] | 151 (16) | 11.2 (0) | 76.8 (0) | 0 | 9.3 (25) | 0.7 | 2 (100) |
32 | Lohiya et al. (2016) [51] | 250 | 4 | 88 | 2 | 1.6 | 0.8 | 3.6 |
33 | Kasliwal et al. (2016) [52] | 411 (97) | 0.5 | 94.2 (2.6) | 0 | 3.5 (22.2) | 0 | 1.7 (100) |
34 | Khatib et al. (2016) [53] | 287 (287) | 0.7 (0) | 87.8 (3.3) | 3.5 (20) | 4.2 (25) | 1.7 (80) | 2.1 (100) |
35 | Pantola et al. (2016) [54] | 218 (44) | 5.5 (0) | 69.3 (0) | 10.5 (8.3) | 8.2 (10) | 2.3 (100) | 4.1 (100) |
36 | Solanki et al. (2016) [56] | 1,287 (62) | 22 (18.2) | 73.9 (2.6) | 0.7 (0) | 1.5 (50) | 0.4 (50) | 1.3 (100) |
37 | Kannan et al. (2017) [60] | 404 (243) | 7.7 (28.6) | 40.8 (13) | 24.3 (41.7) | 10.6 (46.9) | 6.9 (96.3) | 9.7 (100) |
38 | Mahajan et al. (2017) [61] | 4,532 (335) | 3.5 (50) | 79.6 (7.8) | 2.5 (50) | 3.9 (23.6) | 0.5 (75) | 9.8 (85.4) |
39 | Chandra et al. (2017) [62] | 971d | 5.5 | 74.9 | 6.4 (51.4) | 2.6 | 3.2 | 7 |
40 | Laishram et al. (2017) [63] | 576 (11) | 5.2 | 89.9 | 0 | 2.2 (40) | 0.3 | 2.2 (100) |
Category |
ROM |
RON |
|||||||
---|---|---|---|---|---|---|---|---|---|
Studies included for ROM | Pooled ROM (95% CI, %) | I2 (%) | p-value | ROM as per TBSRTC (%) [5] | Studies included for RON | Pooled RON (95% CI, %) | I2 (%) | p-value | |
I | 18 | 15 (6–24) | 11.8 | .34 | 1–4 | 15 | 34 (17–52) | 65.5 | .01 |
II | 28 | 3 (2–4) | 54 | .00 | 0–3 | 23 | 8 (6–10) | 80.3 | .00 |
III | 15 | 34 (23–45) | 57.9 | .01 | 5–15 | 11 | 62 (44–81) | 77.4 | .00 |
IV | 27 | 26 (15–36) | 87.2 | .00 | 15–30 | 23 | 81 (73–89) | 77.2 | .00 |
V | 21 | 69 (55–84) | 87.7 | .00 | 60–75 | 17 | 76 (62–90) | 64.1 | .00 |
VI | 28 | 94 (89–98) | 56.3 | .03 | 97–99 | 24 | 95 (90–99) | 58.1 | .05 |
No. | Study | Place | Needle size and technique | Wet fixation | Staining technique used |
Reporting system followed | |
---|---|---|---|---|---|---|---|
Wet fixation | Air-dried smears | ||||||
1 | Mandreker et al. (1995) [13] | Goa | n/s | n/s | n/s | Unsatisfactory, benign, SFM, malignant | |
2 | Sirpal (1996) [14] | Delhi | 21G | n/s | Pap, H&E | Leishman-Giemsa | Malignant, non-neoplastic, FN, Hurthle cell tumors, thyroglossal cyst, extrathyroidal, inconclusive when unsatisfactory |
3 | Handa et al. (2008) [15] | Chandigarh | 23G ± aspiration, manual |
n/s | Pap, H&E | MGG | n/s |
4 | Guhamallick et al. (2008) [16] | Kolkata | 23–24G + aspiration | n/s | Pap, H&E | Leishman-Giemsa | Unsatisfactory, non-neoplastic, indeterminate, malignant |
5 | Gupta et al. (2010) [17] | Jammu and Kashmir | n/s | Ether-95% alcohol solution | Pap | n/s | Benign, FN, SFM, malignant |
6 | Bagga and Mahajan (2010) [18] | Haryana | 23–25G, non-aspiration |
95% Ethanol | H&E | MGG | Unsatisfactory, benign, SFM, malignant |
7 | Sengupta et al. (2011) [19] | Bihar | 22–23G + aspiration |
n/s | n/s | MGG | Colloid goiter, granulomatous thyroiditis, FA, FC, anaplastic carcinoma |
8 | Renuka et al. (2012) [20] | Andhra Pradesh | 22G ± aspiration, USG in some | 95% Methanol | Pap, H&E | MGG | TBSRTC |
9 | Sharma and Mathur (2012) [21] | Rajasthan | 23G + aspiration | Ether-95% alcohol solution | Pap, H&E | Giemsa | Unsatisfactory, non-neoplastic, FN, SFM, malignant (RCP) |
10 | Patel et al. (2013) [22] | Gujarat | 23–24G ± aspiration |
95% Ethanol | Pap, H&E | MGG | Non-neoplastic, neoplastic, others |
11 | Mondal et al. (2013) [23] | West Bengal | n/s, USG in some |
n/s | Pap | Leishman-Giemsa | TBSTRC |
12 | Kukar et al. (2013) [24] | Punjab | n/s |
95% isopropanol | Pap, H&E | MGG | Non-neoplastic, neoplastic |
13 | Bhasin et al. (2013) [25] | Punjab | n/s | n/s | n/s; MGG as per figures | TBSRTC | |
14 | Borgohain et al. (2014) [26] | Assam | n/s | n/s | n/s | MGG | Non-neoplastic, neoplastic |
15 | Mangshetty et al. (2014) [27] | Karnataka | 22–24G + aspiration | Alcohol | Pap | MGG | Unsatisfactory, benign, malignant |
16 | Panchal et al. (2014) [28] | Maharashtra | 22/23G + aspiration | 95% Ethanol | Pap | n/s | Unsatisfactory, benign, SFM, malignant |
17 | Pathak et al. (2014) [29] | Delhi | n/s | n/s | Pap | MGG | TBSRTC |
18 | Sukumaran et al. (2014) [30] | Kerala | n/s | 95% alcohol | Pap | n/s | TBSRTC |
19 | Arul and Masilamani (2015) [31] | Tamil Nadu | n/s | n/s | n/s, H&E as per figures | TBSRTC | |
20 | Arul et al. (2015) [32] | Tamil Nadu | n/s, USG if small lesion |
n/s | H&E | MGG | TBSRTC |
21 | Sekhar et al. (2015) [33] | Karnataka | 23–24G + aspiration | 95% Ethanol | Pap, H&E | MGG | TBSRTC |
22 | Mehra and Verma (2015) [34] | Delhi | n/s, USG in all | n/s | Pap | MGG | TBSRTC |
23 | Agrawal et al. (2015) [35] | Uttar Pradesh | 23G + aspiration | 95% Ethanol | Pap, H&E | MGG | TBSRTC |
24 | Sharma (2015) [36] | Tamil Nadu | n/s, manual | n/s | n/s | Unsatisfactory, benign, follicular pattern lesions, suspicious (includes atypical), malignant | |
25 | Thakkar et al. (2015) [37] | Gujarat | 22/24G + aspiration |
n/s | H&E | MGG | TBSRTC |
26 | Garg et al. (2015) [38] | Gujarat | 23–24G + aspiration |
n/s | n/s | TBSRTC | |
27 | Kathirvel (2015) [39] | Tamil Nadu | 25–27G | 100% Isopropanol | H&E | TBSRTC | |
28 | Alagarsamy et al. (2015) [40] | Tamil Nadu | 23G ± aspiration | 100% Isopropanol | H&E | n/s | Colloid goiter, adenoma, carcinoma, others |
29 | Mamatha et al. (2015) [42] | Telangana | n/s | n/s | n/s | n/s | Unsatisfactory, colloid cyst/goiter, follicular lesions/ neoplasm, indeterminate, SFM, malignant as well as TBSRTC |
30 | Gupta et al. (2015) [43] | Uttar Pradesh | n/s | n/s | Pap | Diff-Quick | Histopathological equivalents as well as TBSRTC |
31 | Hathila et al. (2016) [41] | Gujarat | 23G, non-aspiration | 95% Ethanol | Pap, H&E | MGG | Benign, malignant |
32 | Shankar et al. (2016) [44] | Tamil Nadu | n/s + aspiration | n/s | Pap | n/s | TBSRTC |
33 | Prathima et al. (2016) [45] | Karnataka | n/s, USG in some | Alcohol | Pap, H&E | Giemsa | TBSRTC |
34 | Mehrotra et al. (2016) [46] | Karnataka | n/s ± aspiration, USG in some | 95% Ethanol | H&E | MGG | TBSRTC |
35 | Tagore et al. (2016) [47] | Karnataka | 22G + aspiration | Alcohol | Pap | MGG | TBSRTC |
36 | Kalita and Das (2016) [48] | Assam | 23G ± aspiration | n/s | n/s | MGG | TBSRTC |
37 | Bhartiya et al. (2016) [49] | Bihar | 23–24G + aspiration, USG in some |
Wet fixed | Pap | Leishman-Giemsa | TBSRTC |
38 | Kulkarni et al. (2016) [50] | Madhya Pradesh | n/s | n/s | Pap | n/s | TBSRTC |
39 | Lohiya et al. (2016) [51] | Rajasthan | 23/24G | n/s | n/s | MGG | TBSRTC |
40 | Kasliwal et al. (2016) [52] | 24–26G + aspiration | 95% Ethanol | H&E | MGG | TBSRTC | |
41 | Khatib et al. (2016) [53] | Maharashtra | n/s, USG if unsatisfactory | n/s | Pap | Giemsa | TBSRTC |
42 | Pantola et al. (2016) [54] | Tamil Nadu | 23G | 95% Alcohol | Pap, H&E | MGG | TBSRTC |
43 | Babu et al. (2016) [55] | Tamil Nadu | 23G | Ether-95% alcohol solution | Pap | n/s | Unsatisfactory, benign, malignant |
44 | Solanki et al. (2016) [56] | Rajasthan | n/s | n/s | H&E | MGG | TBSRTC |
45 | Aramani and Gururajaprasad (2017) [57] | Karnataka | 24–25G + aspiration | 95% Ethanol | Pap, H&E | MGG | Benign, malignant |
46 | Sunder and Khan (2017) [58], |
Telangana | 23/25/26G + aspiration | 95% Ethyl alcohol or isopropanol | Pap, H&E | MGG | Benign, malignant |
47 | Garg et al. (2017) [59] | Maharashtra | n/s ± aspiration, USG in all | n/s | Pap | MGG | TBSRTC |
48 | Kannan et al. (2017) [60] | Karnataka | n/s |
n/s | n/s | n/s | TBSRTC |
49 | Mahajan et al. (2017) [61] | Chandigarh | n/s | n/s | n/s | n/s | TBSRTC |
50 | Chandra et al. (2017) [62] | Uttarakhand | 26–28G | Alcohol | Pap, H&E | MGG | TBSRTC |
51 | Laishram et al. (2017) [63] | Manipur | n/s | n/s | n/s | MGG | TBSRTC |
No. | Study | Thyroid FNA (operated nodules) | Distribution of the Bethesda categories and corresponding risk of malignancy (%) |
|||||
---|---|---|---|---|---|---|---|---|
I | II | III | IV | V | VI | |||
1 | Mandreker et al. (1995) [13] | 1,992 (238) | 12.7 | 78.2 (5.5) | - | - | 7.6 (26.3) | 1.5 (91.7) |
2 | Sirpal (1996) [14] | 1,114 |
0.6 |
97.1 (0) | - | 1 (11.1) | - | 1.3 (100) |
3 | Handa et al. (2008) [15] | 434 (66) | 5.1 | 87.8 (1.9) | - | 3.2 (0) | - | 3.9 (100) |
4 | Guhamallick et al. (2008) [16] | 288 (75) | 13.5 | 68.4 (3.1) | - | 9.4 (30) | - | 8.7 (95.6) |
5 | Gupta et al. (2010) [17] | 75 (75) | - | 60 (6.7) | - | 24 (16.7) | 4 (0) | 12 (100) |
6 | Bagga and Mahajan (2010) [18] | 252 (32) | 1.6 | 90.5 | - | - | 6.7 | 1.2 |
7 | Renuka et al. (2012) [20] | 564 | 17 | 70.5 | 1.9 | 4.2 | 2.6 | 3.5 |
8 | Sharma and Mathur (2012) [21] | 94 (76) | 2.1 | 53.2 (0) | - | 35.1 (10) | 2.1 (100) | 7.4 (100) |
9 | Mondal et al. (2013) [23] | 1,020 (323) | 1.2 (0) | 87.5 (4.5) | 1 (20) | 4.2 (30.6) | 1.4 (75) | 4.7 (97.8) |
10 | Bhasin et al. (2013) [25] | 80 | 1.2 | 61.2 | 10 | 20 | 3.8 | 3.8 |
11 | Panchal et al. (2014) [28] | 300 (36) | - | 98.7 | - | - | 0.3 | 1 |
12 | Pathak et al. (2014) [29] | 454 | 25.7 | 59 | 6 | 4 | 1.8 | 3.5 |
13 | Sukumaran et al. (2014) [30] | 248 (248) | 6 (6.7) | 12.5 (12.9) | 4.4 (54.6) | 13.3 (87.9) | 4 (100) | 59.7 (100) |
14 | Arul and Masilamani (2015) [31] | 483 (209) | 5 (8.3) | 44.5 (1.1) | 2.9 (0) | 21.5 (11.5) | 15.3 (96.9) | 10.8 (100) |
15 | Arul et al. (2015) [32] | 603 (392) | 2.7 (0) | 65.2 (1.2) | 10 (24.4) | 10.6 (28.9) | 5.3 (70.8) | 6.3 (100) |
16 | Sekhar et al. (2015) [33] | 150 (64) | 2.6 (0) | 76.6 (0) | 0.7 | 12.7 (5.9) | 2.7 (100) | 4.7 (66.7) |
17 | Mehra and Verma (2015) [34] | 225 (40) | 7.2 (0) | 80 (13) | 4.9 (100) |
2.2 (25) | 3.5 (50) | 2.2 (100) |
18 | Agrawal et al. (2015) [35] | 281 (134) | 2.5 (0) | 87.9 (1.8) | 3.9 | 2.5 (18.2) | 1.8 (80) | 1.4 (100) |
19 | Sharma (2015) [36] | 724 (724) | - | 87.7 (1.3) | - | - | 2.9 (52.4) | 9.4 (97.1) |
20 | Thakkar et al. (2015) [37] | 134 (24) | 4.5 (0) | 85.8 (0) | 0.7 | 7.5 (33.3) | 0.7 | 0.7 |
21 | Garg et al. (2015) [38] | 100 (60) | 6 (20) | 78 (0) | 4 (25) | 5 (20) | 3 (66.7) | 4 (100) |
22 | Kathirvel (2015) [39] | 59 | 15.3 | 16.9 | 15.3 | 16.9 | 15.3 | 20.3 |
23 | Mamatha et al. (2015) [42] | 240 (214) | 10.8 | 59.2 (0) | 4.2 (50) | 15 (6.7) | 4.2 (60) | 6.6 (100) |
24 | Gupta et al. (2015) [43] | 300 | 11 | 78 | 2 | 3 | 1 | 5 |
25 | Shankar et al. (2016) [44] | 402 (92) | 10.7 (0) | 81.6 (1.6) | 1.2 (0) | 1.7 (28.6) | 2 (71.4) | 2.7 (80) |
26 | Prathima et al. (2016) [45] | 178 (60) | 11.7 (33.3) | 77.5 (7.1) | 1.1 (50) | 3.9 (25) | 2.2 (66.7) | 3.3 (100) |
27 | Mehrotra et al. (2016) [46] | 175 (34) | 4.6 | 68.6 (0) | 5.7 | 17.1 (0) | 1.1 |
2.9 |
28 | Tagore et al. (2016) [47] | 100 | 3 | 81 | 0 | 9 | 3 | 4 |
29 | Kalita and Das (2016) [48] | 664 | 12 | 72.3 | 1.8 | 4.8 | 1.5 | 7.5 |
30 | Bhartiya et al. (2016) [49] | 238 (105) | 5.9 | 84 (2) | 1.3 | 2.9 (0) | 2.5 | 3.4 (100) |
31 | Kulkarni et al. (2016) [50] | 151 (16) | 11.2 (0) | 76.8 (0) | 0 | 9.3 (25) | 0.7 | 2 (100) |
32 | Lohiya et al. (2016) [51] | 250 | 4 | 88 | 2 | 1.6 | 0.8 | 3.6 |
33 | Kasliwal et al. (2016) [52] | 411 (97) | 0.5 | 94.2 (2.6) | 0 | 3.5 (22.2) | 0 | 1.7 (100) |
34 | Khatib et al. (2016) [53] | 287 (287) | 0.7 (0) | 87.8 (3.3) | 3.5 (20) | 4.2 (25) | 1.7 (80) | 2.1 (100) |
35 | Pantola et al. (2016) [54] | 218 (44) | 5.5 (0) | 69.3 (0) | 10.5 (8.3) | 8.2 (10) | 2.3 (100) | 4.1 (100) |
36 | Solanki et al. (2016) [56] | 1,287 (62) | 22 (18.2) | 73.9 (2.6) | 0.7 (0) | 1.5 (50) | 0.4 (50) | 1.3 (100) |
37 | Kannan et al. (2017) [60] | 404 (243) | 7.7 (28.6) | 40.8 (13) | 24.3 (41.7) | 10.6 (46.9) | 6.9 (96.3) | 9.7 (100) |
38 | Mahajan et al. (2017) [61] | 4,532 (335) | 3.5 (50) | 79.6 (7.8) | 2.5 (50) | 3.9 (23.6) | 0.5 (75) | 9.8 (85.4) |
39 | Chandra et al. (2017) [62] | 971 |
5.5 | 74.9 | 6.4 (51.4) | 2.6 | 3.2 | 7 |
40 | Laishram et al. (2017) [63] | 576 (11) | 5.2 | 89.9 | 0 | 2.2 (40) | 0.3 | 2.2 (100) |
Category | ROM |
RON |
|||||||
---|---|---|---|---|---|---|---|---|---|
Studies included for ROM | Pooled ROM (95% CI, %) | I2 (%) | p-value | ROM as per TBSRTC (%) [5] | Studies included for RON | Pooled RON (95% CI, %) | I2 (%) | p-value | |
I | 18 | 15 (6–24) | 11.8 | .34 | 1–4 | 15 | 34 (17–52) | 65.5 | .01 |
II | 28 | 3 (2–4) | 54 | .00 | 0–3 | 23 | 8 (6–10) | 80.3 | .00 |
III | 15 | 34 (23–45) | 57.9 | .01 | 5–15 | 11 | 62 (44–81) | 77.4 | .00 |
IV | 27 | 26 (15–36) | 87.2 | .00 | 15–30 | 23 | 81 (73–89) | 77.2 | .00 |
V | 21 | 69 (55–84) | 87.7 | .00 | 60–75 | 17 | 76 (62–90) | 64.1 | .00 |
VI | 28 | 94 (89–98) | 56.3 | .03 | 97–99 | 24 | 95 (90–99) | 58.1 | .05 |
FNA, fine needle aspiration; n/s, not specified; SFM, suspicious for malignancy; Pap, Papanicolaou stain; H&E, hematoxylin and eosin; FN, follicular neoplasm; MGG, May-Grünwald-Giemsa; FA, follicular adenoma; FC, follicular carcinoma; USG, ultrasound-guided aspirate; TBSRTC, The Bethesda System for Reporting Thyroid Cytopathology; RCP, Royal College of Pathologists guidelines. FNA performed by cytopathologist; FNA performed by clinician.
FNA, fine-needle aspiration. Excluding nine extrathyroidal; After adjustment of “inconclusive” to the Bethesda terminology; Only one case with available histology; Included 35 cases of category III with surgical follow-up.
ROM, risk of malignancy; CI, confidence interval; TBSRTC, the Bethesda System for Reporting Thyroid Cytopathology; RON, risk of neoplasia.