Sensitivity and specificity of fine needle aspiration biopsies performed in patients undergoing thyroidectomy

Authors

DOI:

https://doi.org/10.33448/rsd-v11i7.29440

Keywords:

Thyroid Neoplasms; Thyroidectomy; Fine Needle Aspiration Biopsy.

Abstract

Objective: To identify the sensitivity and specificity of Fine-Needle Aspiration Biopsies (FNAB) performed at Hospital Regional da Asa Norte (HRAN) for the diagnosis of thyroid cancer in patients submitted to thyroidectomy. Methods: This was an observational and analytical study, which analyzed medical records of patients submitted to FNAB at HRAN from April 2015 to December 2021. The data were descriptively analyzed using the SPSS 2.0 program, and using the ROC Curve, considering a p value <0.05 as statistically significant. Results: 699 patients were submitted to FNAB. 62 patients were undergoing biopsy and surgery after. FNAB sensitivity and specificity were 90.32% and 83.87%, respectively (p <0.001). Most patients were females (96.78%), aged > 60 years (32.25%) and were submitted to total thyroidectomy (66.12%). Among the analyzed cytopathological samples, the Bethesda II classification predominated (25.80%), followed by class V (22.58%). In the histopathological analysis, the predominant diagnosis was papillary carcinoma (43.54%) followed by goiter (38.70%). Among classes I and II, only one sample was considered malignant after the histopathological analysis. Among class III samples, 22.22% were, in fact, malignant lesions. Among the samples suspected of malignancy (Bethesda IV, V and VI), there was a progressive increase in the rate of cancer diagnosis, of 62.50%, 85.71% and 100%, respectively. The FNAB results showed an accuracy of 87.09%. Conclusions: The results of this study are compatible with the findings in the literature. Thus, FNAB remains the gold standard for the analysis of thyroid nodules until another more sensitive and specific method is described.

Author Biography

Lucas Ribeiro Canedo, Hospital Regional da Asa Norte

 

 

References

Ali, S. Z. (2011). Thyroid cytopathology: Bethesda and beyond. Acta Cytol, Nov, 55(1): 4–12, DOI: 10.1159/000322365.

Bongiovanni, M., Crippa, S., Baloch, Z., Piana, S., Spitale, A., Pagni, F., et al. (2012). Comparison of 5-tiered and 6-tiered diagnostic systems for the reporting of thyroid cytopathology: a multi-institutional study. Cancer Cytophatol, Apr,120(2):117-25. DOI: 10.1002/cncy.20195.

Bongiovanni, M., Krane, J. .F., Cibas, E. S., Faquin, W. C. (2012). The atypical thyroid fine-needle aspiration: past, present, and future. Cancer Cytopathol, Apr, 120(2):73-86. DOI: 10.1002/cncy.20178.

Cibas, E. S., Baloch, Z. W., Felegara, G., et al. (2013). A prospective assessment defining the limitations of thyroid nodule pathologic evaluation. Ann Intern Med, Sep,159(5):325-32. DOI: 10.7326/0003-4819-159-5-201309030-00006.

Cibas, E. S. & Ali, S. Z. (2009). The Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol, Nov, 132(5):658-65. DOI: 10.1309/AJCPPHLWMI3JV4LA..

Cibas, E. S. & Ali, S. Z. (2017). The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid, Nov, 27(11):1341-1346. DOI: 10.1089/thy.2017.0500.

DeGroot, L. J. & Pacini, F. (2012). Guideline of Thyroid Nodules. Thyroid Disease Manager.

DeLellis, R. A., Lloyd, R. V., Heitz, P. U., Eng, C. (2004). Pathology and genetics of tumours of endocrine organs. Lyon: IARC Press. WHO Classification of Tumours, 3rd edition, v. 8.

Escalante, D. A. & Anderson, K. G. (2022). Workup and Management of Thyroid Nodules. Surg Clin N Am, Apr , 102(2):285–307. DOI: 10.1016/j.suc.2021.12.006.

Eszlinger, M., Hegedus, L., Paschke, R. (2014). Ruling in or ruling out thyroid malignancy by molecular diagnostics of thyreoids. Best Practice & Research Clinical Endocrinology & Metabolism, Aug, 28(4):545-57. DOI: 10.1016/j.beem.2014.01.011.

Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., et al. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN. International Journal of Cancer, Mar, 136,5:359-386. DOI: 10.1002/ijc.29210.

Forman, D., Bray, F., Brewster, D. H., Gombe Mbalawa, C., Kohler, B., Piñeros, M., et al. (2014). (Ed.) Cancer Incidence in five continents: vol X, 164. Lyon: IARC, (IARC Scientific Publications).

Gharib, H., Papini, E., Valcavi, R., Baskin, H. J., Crescenzi, A., Dottorini, M. E., et al., (2006). American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract Jan, 12(1): 63–102. DOI: 10.4158/EP.12.1.63.

Girardi, F. M., Barra, M. B., Zettler, C. G. (2015). Carcinoma papilífero da tireoide: a associação com tireoidite de Hashimoto influencia nas características clínico-patológicas da doença? Braz J Otorhinolaryngol, Mai, 81(3):283-7. DOI: 10.1016/j.bjorl.2014.04.006.

Hassell, L. A., Gillies, E. M., Dunn, S. T. (2012). Cytologic and molecular diagnosis of thyroid cancers: is it time for routine reflex testing? Cancer Cytopathol, Feb,120(1):7-17. DOI: 10.1002/cncy.20186.

Holt, E. H. (2021). Current Evaluation of Thyroid Nodules. Med Clin N Am, Nov,105(6):1017–1031. DOI: 10.1016/j.mcna.2021.06.006.

Horne, M. J., Chhieng, D. C., Theoharis, C. et al. (2012). Thyroid follicular lesion of undetermined significance: Evaluation of the risk of malignancy using the two-tier sub classification. Diagn Cytopathol, Feb, 40:410-5. DOI: 10.1002/dc.21790.

Houdek, D., Cooke-Hubley, S., Puttagunta, L., Morrish, D. (2021).Factors affecting thyroid nodule fine needle aspiration non‐diagnostic rates: a retrospective association study of 1975 thyroid biopsies. Thyroid Research, Fev, 14:2. DOI: 10.1186/s13044-021-00093-2.

Idarraga, A. J., Luong, G., Hsiao, V., Schneider, D. F. (2021). False Negative Rates in Benign Thyroid Nodule Diagnosis: Machine Learning for Detecting Malignancy. Journal of Surgical Research, Dec, 268:562-569. DOI: 10.1016/j.jss.2021.06.076.

Kim M., Park, H. J., Min, H. S., Kwon, H. J., Jung, C. K., et al. (2017): The use of Bethesda system for reporting thyreoid citopatology in Korea: A nationwide multicenter survey by the Korean Society of endocrine pathologists. J Pathol Transl Med, Jul,51(4):410-417. DOI: 10.4132/jptm.2017.04.05.

Köseoglu, D., Baser, O. O., Çetin, Z. (2021). Malignancy outcomes and the impact of repeat fine needle aspiration of thyroid nodules with Bethesda category III cytology: A multicenter experience. Diagnostic Cytopathology, Oct, 49(10):1110–1115. DOI: 10.1002/dc.24823.

La Vecchia, C., Malvezzi, M., Bosetti, C., Garavello, W., Bertuccio, P., Levi, F., et al. (2015). Thyroid cancer mortality and incidence: a global overview. Int J Cancer, May, 136(9):2187-95. DOI:10.1002/ijc.29251.

Levorato, C. D., et al. (2014). Fatores associados à procura por serviços de saúde numa perspectiva relacional de gênero. Ciênc. Saúde Coletiva, Apr, 19 (4):1263-1274.

Mazzaferri, E. L. (1993). Management of a solitary thyroid nodule. N Engl J Med., Feb 25,328(8):553-9. doi: 10.1056/NEJM199302253280807.

Medeiros-neto, G., Camargo, R. Y. A., Tomimori, E. K. (1998). Thyroid Manager. Arq Bras Endocrinol Metab, Ago, 42 (4): 323-327. DOI:10.1590/S0004-27301998000400014.

Mezei, T., Kolcsár, M., Pașcanu, I., Vielh, P. (2021). False positive cases in thyroid cytopathology – the experience of a single laboratory and a systematic review. Cytopathology, Apr. 32(4):493–504. DOI: 10.1111/cyt.12984.

Nguyen, Q. T., Lee, E. J., Huang, M. G., Park, Y. I., Khullar, A., Plodkowski, R. A. (2015). Diagnosis and Treatment of Patients with Thyroid Cancer. Am Health Drug Benefits, Feb, 8(1):30-40.

Powers, A. E., Marcadis, A. R., Lee, M., Morris, L. G. T., Marti, J. L. (2019). Changes in Trends in Thyroid Cancer Incidence in the United States, 1992 to 2016. JAMA, Dec, 322(24):2440–2441. DOI:10.1001/jama.2019.18528.

Quaglino, R., Marchese, V., Mazza, E., Gottero, C., Lemini, R., Taraglio, S. (2017). When Is Thyroidectomy the Right Choice? Comparison between Fine-Needle Aspiration and Final Histology in a Single Institution Experience. Eur Thyroid J, Apr, 6(2):94–100, DOI: 10.1159/000452622.

Rago, T. & Vitti, P. (2022). Risk Stratification of Thyroid Nodules: From Ultrasound Features to TIRADS. Cancers, Jan, 14(3): 717-729. DOI: 10.3390/cancers14030717.

Reiners, C., Wegscheider, K., Schicha, H., Theissen, P., Vaupel, R. et al. (2004). Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid, Nov,14(11):926-32. DOI:10.1089/thy.2004.14.926.

Roberti, A. & Rapoport, A. (2005). Prevalence of thyroid diseases in patients submitted to thyroidectomy at the Santa Casa de Goiânia Hospital. Rev Col Bras Cir, Sept/Oct, 32,(5): 226-228. DO:10.1590/S0100-69912005000500002.

Santos, M. O., (2018). Estimativa 2018: incidência de câncer no Brasil. Revista Brasileira de Cancerologia, Jan, 64(1): 119-120. DOI: 10.32635/2176-9745.RBC.2018v64n1.115.

Steinmetz-Wood, S. N. , Kennedy, A. G., Tompkins, B. J., Gilbert, M. P. (2022). Navigating the Debate on Managing Large (≥4 cm) Thyroid Nodules. International Journal of Endocrinology, eCollection, Volume 2022, Apr, Article ID 6246150. DOI: 10.1155/2022/6246150.

Vander, J. B., Gaston, E. A., Dawber, T. R. (1968). The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med, Sep, 69(3):537-40. DOI:10.7326/0003-4819-69-3-537.

Zhao, N., Yao, M., Han, R., Chen, W., Zhang, F., Feng, Y. (2022).The diagnostic value of second ultrasound-guided fine-needle aspiration for thyroid nodules. J Clin Ultrasound, Jan, 50(3):405–410. DOI: 10.1002/jcu.23119.

Downloads

Published

17/05/2022

How to Cite

CANEDO, L. R. .; SANTANA, V. M. X. de .; REIS, R. dos .; FURTADO, W. dos S. .; NASCIMENTO, A. A. do .; CARVALHO, A. L. A. de . Sensitivity and specificity of fine needle aspiration biopsies performed in patients undergoing thyroidectomy. Research, Society and Development, [S. l.], v. 11, n. 7, p. e12311729440, 2022. DOI: 10.33448/rsd-v11i7.29440. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29440. Acesso em: 25 apr. 2024.

Issue

Section

Health Sciences