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JPTM > Volume 51(6); 2017 > Article
Journal of Pathology and Translational Medicine 2017;51(6): 565-570.
doi: https://doi.org/10.4132/jptm.2017.08.12
Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand
Somboon Keelawat1, Samreung Rangdaeng2, Supinda Koonmee3, Tikamporn Jitpasutham1, Andrey Bychkov1
1Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
2Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
3Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Corresponding Author: Andrey Bychkov ,Tel: +66-2-256-4235, Fax: +66-2-652-4208, Email: andrey.b@chula.ac.th
Received: August 3, 2017;  Revised: August 10, 2017  Accepted: August 11, 2017.  Published online: November 15, 2017.
Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings. Currently, the Bethesda system is actively promoted by the local professional societies as a uniform reporting system. Experience with thyroid FNA has been rarely reported to date—only a handful of publications are available in local journals. Our review, in addition to presenting various aspects of thyroid FNA in Thailand, established for the first time national references for a certain statistical outputs of TBSRTC based on the original multi-institutional cohort. The risk of malignancy in 2,017 operated thyroid nodules collected from three tertiary thyroid cancer centers was 21.7%, 14.7%, 35.9%, 44.4%, 76.7%, and 92.6% for categories I to VI, respectively. The malignancy risk in several diagnostic categories (II to IV) was higher than the risk estimated by TBSRTC and recent meta-analysis studies. We endorse the use of uniform terminology of the Bethesda system in Thailand, which will help facilitate communication among diverse medical professionals involved in the management of patients with thyroid nodules, to share local experience with the international audience.
Key Words: Fine-needle aspiration cytology; Thyroid fine-needle aspiration; The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC); Review; Thailand