Publication: Fine-needle aspiration of thyroid nodule : correlating malignant histology outcomes with cytology results in Hospital Sultanah Nur Zahirah (1022-2015)
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Date
2018
Authors
Jusoh@Yusoff, Yusri Rahimi @ Mohd
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Abstract
Introduction:
Thyroid nodule is increasingly important especially in a case of suspicious for malignancy.
FNAC is a gold standard for assessment of thyroid nodule. It also imperative as a tool to ‘rule
in’ malignancy as proper surgical excision can be planned and to ‘rule out’ malignancy to
prevent unnecessary surgery. US can act as adjunct to further evaluate the thyroid nodule
especially when nodule is small (<1cm) and not palpable.
Objective:
The main objective is to study the agreement between cytopathology and histopathology in
thyroidectomy patients and to identify the associated risks of malignancy in patients with
thyroidectomy.
Methods:
Between January 2011 and December 2015, patients who underwent thyroidectomy with preoperative
FNAC in Hospital Sultanah Nur Zahirah, Kuala Terengganu were reviewed. The
demographic data were collected and documented. Analysis and comparison of final
histopathology were conducted and the specificity and sensitivity study of thyroid FNAC were
calculated and recorded. The discussion for associated risk for thyroid malignancy including
age, gender, race, thyroid status, symptomatic nodule and pre-operative ultrasound finding.
Results:
301 patients (274 female 27 male) had thyroid surgery. The pre-operative cytological diagnosis
was made according to following categories: Benign, AUS, Follicular lesion, Malignant and
Inadequate sampling. There are 141 cases in benign cytology category, 34 cases from follicular
category, 19 patients from malignant category and 62 patients from inadequate sampling group.
The agreement between cytopathology and histopathology was K = 0.44 with 95% CI = (0.35,
0.53). Kappa value shows that cytopathology and histopathology has moderate agreement in
determining malignant and non-malignant in this study. The overall results showed a sensitivity
of 63%, specificity of 81%, and positive predictive value of 61%, negative predictive value of
82% and diagnostic accuracy of 75%.
Conclusion:
We conclude that FNAC is a valuable and minimally invasive procedure for pre-operative
assessment of patients with thyroid nodules. FNAC has high sensitivity in picking up thyroid
malignancy in thyroid and has high diagnostic accuracy in the evaluation of thyroid nodules.
Description
Keywords
Thyroidectomy