sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.15372/SSMJ20200509sibmed-491Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEСравнение метода тонкоигольной аспирационной цитологии с гистопатологией у пациентов с разрастанием щитовидной железы в больнице третичного уровня в Южной ИндииCorrelation of fine needle aspiration cytology with histopathology for thyroid swellings in a tertiary care hospital in South Indiahttps://orcid.org/0000-0002-3239-6631PereiraC.PereiraC.

Chirag Pereira, Assistant Professor

Karnataka, 575002 Mangalore, Father Muller rd.

Chirag Pereira, Assistant Professor

Karnataka, 575002 Mangalore, Father Muller rd.

chiggy1989@gmail.comhttps://orcid.org/0000-0002-8873-5372RohanD.RohanD.

Rohan Dsouza, Assistant Professor 

Karnataka, 575002 Mangalore, Father Muller rd.

Rohan Dsouza, Assistant Professor

Karnataka, 575002 Mangalore, Father Muller rd.

TauroL. F.TauroL. F.

Leo F. Tauro, Professor and HOD

Karnataka, 575002 Mangalore, Father Muller rd.

Leo F. Tauro, Professor and HOD

Karnataka, 575002 Mangalore, Father Muller rd.

drlftauro@rediffmail.comFather Muller Medical CollegeИндияFather Muller Medical CollegeIndia2020201120204057983Copyright © Pereira C., Rohan D., Tauro L.F., 20202020Pereira C., Rohan D., Tauro L.F.Pereira C., Rohan D., Tauro L.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/491

Подтверждено, что тонкоигольная аспирационная цитология (ТАЦ) является хорошим методом диагностики повреждений щитовидной железы. Метод имеет высокую диагностическую точность и недорогой. Несмотря на вышеперечисленное у него есть свои ограничения, особенно при отличии фолликулярной аденомы от фолликулярной карциномы щитовидной железы. Целями исследования была оценка ТАЦ в диагностике повреждений щитовидной железы путем определения его чувствительности, специфичности, диагностической точности, положительной прогностической ценности и отрицательной прогностической ценности. Материал и методы. Проведено ретроспективное исследование 580 случаев разрастания щитовидной железы, перенесших тиреоидэктомию в течение 5 лет с 2015 по 2020 гг. У пациентов после тиреоидэктомии анализы ТАЦ (система отчетности Bethesda) сравнивали и проанализировали с отчетами гистопатологии. Случаи категории 1 и категории 3 были исключены из расчета из-за неопределенности в отчетности. Данные были проанализированы для расчета чувствительности, специфичности, диагностической точности, положительной прогностической ценности и отрицательной прогностической ценности ТАЦ. Полученные результаты. В исследование были включены 580 пациентов с разрастанием щитовидной железы. Соотношение мужчин и женщин составляло 1 : 18,2, а средний возраст – 43 года. По результатам ТАЦ 428 случаев (73,7 %) были доброкачественными, 35 случаев (6 %) были неопределенными, 39 случаев (6,7 %) были фолликулярными новообразованиями, 30 случаев (5,1 %) были подозрительными на злокачественные новообразования и 34 (5,8 %) были злокачественными. 14 (2,4 %) случаев были неудовлетворительными. Затем цитологический отчет сравнивали с гистопатологическим отчетом. ТАЦ имел чувствительность 84,2 %, специфичность 97,2 % и диагностическую точность 94,5 %. Прогнозирующая ценность положительного и отрицательного прогнозов составила 88,3 и 96 % соответственно. Выводы. При отличии доброкачественных и злокачественных поражений щитовидной железы ТАЦ более специфичен, чем чувствителен. Метод имеет хорошую диагностическую точность и, следовательно, должен использоваться во всех больницах перед операцией для диагностики поражений щитовидной железы.

Fine needle aspiration cytology (FNAC) is documented to be a good tool in the diagnosis of thyroid lesions. It has good diagnostic accuracy and is an inexpensive investigation. Although a good instrument it does have its own limitations especially when it comes to distinguishing a follicular adenoma from follicular carcinoma thyroid. Objectives of the study was the evaluation of FNAC in the diagnosis of thyroid lesions by determining its sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value. Material and methods. This is a retrospective study of 580 cases of thyroid swelling admitted to our hospital and undergone thyroidectomy over a period of 5 years from 2015 to 2020. After thyroidectomy, FNAC reports (Bethesda system for reporting) of those patients were collected and were compared and analyzed with the histopathology reports. Category 1 and category 3 cases were excluded from calculation due to uncertainty in reporting. Data were analyzed to calculate the sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of FNAC. Results. Our study included a total of 580 cases of thyroid swellings. The male to female ratio was 1:18.2 and the median age was 43 years. On FNAC, 428 cases (73.7 %) were benign, 35 cases (6 %) were indeterminate, 39 cases (6.7 %) were follicular neoplasm, 30 cases (5.1 %) were suspicious for malignancy and 34 (5.8 %) were malignant. 14 (2.4 %) cases were unsatisfactory. Cytology report was then compared with histopathological reports. FNAC had a sensitivity of 84.2 %, specificity of 97.2 % and a diagnostic accuracy of 94.5 %. The positive predictive value and negative predictive value were 88.3 and 96 % respectively. Conclusions. FNAC is a more specific than sensitive when distinguishing between benign and malignant lesions of thyroid. It has good diagnostic accuracy and hence should be used in all tertiary care hospitals prior to surgery in diagnosing thyroid lesions.

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The authors declare that there are no conflicts of interest present.