ÖNEMİ BELİRSİZ ATİPİLİ HASTALARDAKİ POSTOPERATİF HİSTOPATOLOJİK MALİGNİTE VARLIĞI

Abstract

Amaç Tiroid kanseri en sık görülen endokrin malignitesidir ve klinik görünümü nodüllerle karakterizedir. Tiroid patolojileri için yapılan biyopsilerde ‘Önemi belirsiz atipi’ (ÖBA) literatürdeki farklı malignite oranları nedeniyle klinisyenler için önemli bir endişe kaynağıdır. Bu çalışmada, AUS tanısı alan ve tiroid cerrahisi geçiren hastalarda malignite oranlarını güncel literatür ışığında sunmayı amaçladık. Gereç ve Yöntem 2016-2021 yılları arasında kliniğimizde ince iğne aspirasyon biyopsisinde (İİAB) ÖBA tanısı alan ve tiroid cerrahisi uygulanan 174 hastanın demografik ve histopatolojik verileri retrospektif olarak analiz edildi. Hastalar histopatolojik özelliklerine göre malign ve benign olarak iki gruba ayrıldı. Gruplar arasındaki istatistiksel anlamlılık Ki-kare ve Student t-testleri kullanılarak belirlenmiştir. P değeri <0.05 olarak kabul edilmiştir. Bulgular Yaş ortalaması 47.9±12 yıl (dağılım, 20-81) idi. Malignite oranı %43,5 idi. Kadınların %42,1'inde, erkeklerin ise %50'sinde malignite tespit edildi. Ortalama nodül çapı 19,1±13,7 mm (1-97 mm) idi. Cinsiyet, yaş ve nodül çapı ile malignite arasında istatistiksel olarak anlamlı ilişki saptanmadı (p>0.05). Sonuç Bethesda sınıflamasına göre ÖBA için malignite oranı %15-30 olarak belirtilmiştir. Çalışmamızda malignite oranı, ülkemizde yapılan benzer çalışmalara benzer olarak, %43.5 saptanmıştır. ÖBA tanısıyla tiroid cerrahisi planlanan vakalarda, yüksek malignite olasılığı nedeniyle, lobektomiye alternatif olarak total tiroidektomi de bir seçenek olarak düşünülmelidir.

Keywords

• ATA kılavuzu
• Bethesda sınıflaması
• İİAB
• Önemi belirsiz atipi
• Tiroid kanseri

PRESENCE OF POSTOPERATIVE HISTOPATHOLOGICAL MALIGNANCY IN PATIENTS WITH ATYPIA OF UNDETERMINED SIGNIFICANCE

Abstract

Objective Thyroid cancer is the most common endocrine Malignancy, and nodules characterize its clinical presentation. 'Atypia of undetermined significance' (AUS) in biopsies performed for thyroid pathologies is an essential concern for clinicians due to different malignancy rates in the literature. In this study, we aimed to discuss the malignancy rates in patients who underwent thyroid surgery for AUS. Material and Method The demographic and histopathologic data of 174 patients diagnosed with AUS on fine needle aspiration biopsy (FNAB) and who underwent thyroid surgery in our clinic between 2016 and 2021 were retrospectively analyzed. According to histopathologic features, patients were divided into two groups, malignant and benign, and the relationship with age, gender, and nodule diameter was investigated. Statistical significance between groups was determined using Chi-square and Student t-tests. P value <0.05 was accepted. Results The mean age was 47.9±12 years (range, 20-81). The malignancy rate was 43.5%. Malignancy was detected in 42.1% of females and 50% of males. The mean nodule diameter was 19.1±13.7 mm (range, 1-97 mm). There was no statistically significant difference between gender, age, nodule diameter, and Malignancy (p>0.05). Conclusion According to the Bethesda classification, the malignancy rate for AUS is 15-30%. In our study, the malignancy rate was 43.5%, similar to studies published in our country. Because of the high malignancy rate, total thyroidectomy should be considered an alternative to lobectomy in cases planned for surgery with a diagnosis of AUS.

Keywords

• ATA guideline
• Atypia of undetermined significance
• Bethesda Classification
• FNAB
• Thyroid malignancy

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