Tirads and Bethesda Scores Application in Thyroid Cancer Diagnosis

Abstract

Introduction: Malignant tumors of the thyroid gland are common in the field of endocrinology as an oncological disease, accounting for 0.5% of all oncological diseases. It also accounts for 5% of malignant oncological tumors in the head and neck area. The incidence rate of thyroid cancer ranges from 3.5% to 8% annually in different countries. Aims: Aim of this study was to evaluate accuracy of thyroid cancer diagnosis by traditional methods and by application of TIRADS and Bethesda systems scores. Methodology: To evaluate the effectiveness of the integrated use of TIRADS and Bethesda systems and their significance in the formation of therapeutic tactics in 90 patients with thyroid cancer were observed with gathering data about clinical signs, complaints, anamnestic data specific to thyroid pathology, history of the disease, blood check for thyroid stimulating hormone (TSH), free T4 (T4), thyroglobulin (TG) level, titre of antibodies against TG (AT-TG); preoperative US-imaging of the thyroid gland performed according to old traditional description and by using TIRADS system, cytological analysis of the FNAB test - according to simple traditional histology description and by using Bethesda classification, operative protocol and express histological analysis of the macropreparation assessed according to the Bethesda classification, as well as final histological analysis. Results: Results showed the complex application of Bethesda systems in cytological examination by FNAB in and US-imaging TIRADS is 4 times more effective with using TIRADS and BETHESDA than in group used conventional classification and method. Moreover, the informativeness of histological examinations described by the Bethesda system were in 1.4 times higher. This indicator of high importance significantly reduces diagnostic errors through the complex use of TIRADS and Bethesda systems in the diagnosis of thyroid cancer. Conclusion: 1. The use of the TIRADS system is the most accurate and effective method of early diagnosis in the assessment of nodal derivatives, especially in the process of diagnosing TC. In particular, the systematic tactics of TIRADS 3, TIRADS 4, TIRADS 5 stages further simplify the diagnostic process. 2. Obtaining conclusions using the Bethesda system in cytological and express histological examinations facilitates intraoperative decision-making for the physician and ensures effective completion of surgical tactics.