Tiroid Kanserlerinde Sitopatoloji
Özet
Tiroid sitopatolojisi, tiroid nodüllerinin tanı ve yönetiminde temel tanısal yöntemlerden biridir. İnce iğne aspirasyon biyopsisi, Bethesda Sistemi’nin sağladığı raporlama standardizasyonu sayesinde malignite riskinin öngörülmesi ve klinik kararların yönlendirilmesinde yüksek güvenilirlik sunmaktadır. 2023 yılında yayımlanan üçüncü baskı ile önemi belirsiz atipi kategorisinin alt sınıflandırılması, malignite risk oranlarının güncellenmesi, pediatrik olgular için ayrı değerlendirmeler ve Dünya Sağlık Örgütü 2022 sınıflamasıyla uyum öne çıkan değişiklikler arasındadır. Raporlama formatının standardize edilmesi, nondiagnostik, benign, önemi belirsiz atipi, foliküler neoplazi, malignite şüphesi ve malign kategoriler için tanı kriterlerinin netleştirilmesi sağlanmıştır. Ayrıca BRAF, RAS, RET/PTC, PAX8/PPARG ve TERT gibi moleküler belirteçlerin tanısal belirsizlikleri azaltmada ve tedavi stratejilerini yönlendirmede artan rolü vurgulanmaktadır. Bethesda 2023, morfolojik ve moleküler verilerin bütünleştirilmesiyle daha doğru, bireyselleştirilmiş hasta yönetimine katkı sağlamaktadır.
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