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An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter

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ABSTRACT

Background: Thyroid cancer (TC) comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40–50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%–30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA) biopsy. The FNA biopsy is favored for its simplicity, safety, and high specificity and sensitivity rates.

Aim: The aim of our study was to evaluate the clinical efficacy of FNA based on the patients’ register.

Materials and methods: In the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, 2,133 patients underwent thyroid surgery for thyroid goiter between 1996 and 2015. One hundred and eight cases of TC were diagnosed and of these, 66 patients had a preoperative FNA.

Results: Fourteen FNA biopsies (21%) revealed cancer, all of which were confirmed in the postoperative histopathology, although six cases of FNA-diagnosed cancer revealed a different histological type postoperatively. Eighteen FNA biopsies (27%) were suspected of being malignant. A disturbingly high rate of “benign” FNA biopsies (32 cases; 48%) revealed TC after surgery.

Conclusion: It is of great importance that the quality and quantity of FNA biopsies that are performed have been improved, especially due to the wide adoption of the Bethesda cytological evaluation system. FNA biopsy remains an obligatory and valuable diagnostic tool in thyroid nodules, but it is still insufficient as a standard procedure. A preoperative biopsy should always be related to all the available clinical data in order to provide the best treatment option for each patient individually.

No MeSH data available.


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Thyroid cancer in postoperative specimen histopathology: 1996–2015.Abbreviation: CA, cancer.
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f1-ott-9-5819: Thyroid cancer in postoperative specimen histopathology: 1996–2015.Abbreviation: CA, cancer.

Mentions: The overall incidence of TC in the study period was 5.06%. Papillary (72 female vs 9 male patients) and follicular TCs (ten female vs three male patients) were mostly diagnosed. Less common findings included: six cases of medullary cancer (two in W, four in M), three cases of anaplastic cancer (two in W, one in M), and two cases of squamous cell TC in W. Furthermore, one case of fibrosarcoma and two metastases from head and neck cancers were diagnosed – all in female patients. The mean age at diagnosis was: 1) papillary cancer, 49 years for M and 51 years for W; 2) follicular cancer, 44 years (M) and 53 years (W); 3) medullary cancer, 53 years (M) and 62 years (W); 4) anaplastic cancer, 80 years (M) and 65 years (W); and 5) squamous cell cancer, 31 years (W) (Table 1). An increase in the number of diagnosed papillary cancer cases was also observed: in the period 1996–2005, there were approximately two cases per year, while in the period 2006–2015, this had increased to almost 5.5 cases per year (Figure 1). The mean size of the thyroid nodules evaluated by ultrasonography was 24.4 mm for right lobe nodules and 23.6 mm for left lobe nodules. Microcalcifications were found in nine cases of right lobe nodules, six cases of left lobe nodules, and in one case bilaterally.


An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter
Thyroid cancer in postoperative specimen histopathology: 1996–2015.Abbreviation: CA, cancer.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5036625&req=5

f1-ott-9-5819: Thyroid cancer in postoperative specimen histopathology: 1996–2015.Abbreviation: CA, cancer.
Mentions: The overall incidence of TC in the study period was 5.06%. Papillary (72 female vs 9 male patients) and follicular TCs (ten female vs three male patients) were mostly diagnosed. Less common findings included: six cases of medullary cancer (two in W, four in M), three cases of anaplastic cancer (two in W, one in M), and two cases of squamous cell TC in W. Furthermore, one case of fibrosarcoma and two metastases from head and neck cancers were diagnosed – all in female patients. The mean age at diagnosis was: 1) papillary cancer, 49 years for M and 51 years for W; 2) follicular cancer, 44 years (M) and 53 years (W); 3) medullary cancer, 53 years (M) and 62 years (W); 4) anaplastic cancer, 80 years (M) and 65 years (W); and 5) squamous cell cancer, 31 years (W) (Table 1). An increase in the number of diagnosed papillary cancer cases was also observed: in the period 1996–2005, there were approximately two cases per year, while in the period 2006–2015, this had increased to almost 5.5 cases per year (Figure 1). The mean size of the thyroid nodules evaluated by ultrasonography was 24.4 mm for right lobe nodules and 23.6 mm for left lobe nodules. Microcalcifications were found in nine cases of right lobe nodules, six cases of left lobe nodules, and in one case bilaterally.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Thyroid cancer (TC) comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40–50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%–30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA) biopsy. The FNA biopsy is favored for its simplicity, safety, and high specificity and sensitivity rates.

Aim: The aim of our study was to evaluate the clinical efficacy of FNA based on the patients’ register.

Materials and methods: In the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, 2,133 patients underwent thyroid surgery for thyroid goiter between 1996 and 2015. One hundred and eight cases of TC were diagnosed and of these, 66 patients had a preoperative FNA.

Results: Fourteen FNA biopsies (21%) revealed cancer, all of which were confirmed in the postoperative histopathology, although six cases of FNA-diagnosed cancer revealed a different histological type postoperatively. Eighteen FNA biopsies (27%) were suspected of being malignant. A disturbingly high rate of “benign” FNA biopsies (32 cases; 48%) revealed TC after surgery.

Conclusion: It is of great importance that the quality and quantity of FNA biopsies that are performed have been improved, especially due to the wide adoption of the Bethesda cytological evaluation system. FNA biopsy remains an obligatory and valuable diagnostic tool in thyroid nodules, but it is still insufficient as a standard procedure. A preoperative biopsy should always be related to all the available clinical data in order to provide the best treatment option for each patient individually.

No MeSH data available.


Related in: MedlinePlus