Tiroid Nodül Boyutu Ve Özelliklerinin İnce İğne Aspirasyon Biyopsisinin Doğruluğu Ve Malignite Riski Üzerine Etkisi

Yıl 2024, , 321 - 330, 14.10.2024

Mehmet Alperen Avcı , Can Akgün , Mustafa Gün , Selim Tamam , Meltem Türk

https://doi.org/10.52827/hititmedj.1501055

Öz

Amaç: Ultrasonografi, tiroid nodüllerinin özelliklerinin incelenmesi ve ince iğne aspirasyon biyopsisinin (İİAB) alınması noktasında kolay, avantajlı ve güvenlik-maliyet etkin bir yöntemdir. Bununla beraber, büyük nodüllerde güvenilirliği tartışmalıdır. Bu çalışmada amacımız ultrasondaki tiroid nodül boyutu ve özelliklerinin malignite riski üzerine ve ince iğne aspirasyon biyopsisinin doğruluğu üzerine etkisini incelemektir.
Gereç ve Yöntem: Çalışmaya, retrospektif olarak 01.01.2020 ile 01.01.2024 tarihleri arasında tiroidektomi operasyonu geçiren 522 hasta dahil edilmiştir. Yaş, cinsiyet, preoperatif ultrason bulguları, preoperatif İİAB sonuçları, ameliyat notları ve postoperatif patoloji bulguları arşivden araştırılmıştır. İstatistiksel analizde Kruskal-Wallis Varyans Analizi, ROC (Receiver Operating Characteristics) eğrisi analizi, Bonferroni Düzeltmeli Mann-Whitney U Testi ve Ki-Kare Testleri kullanılmıştır.
Bulgular: Medyan yaş 49,45 olarak bulundu. Preoperatif İİAB ile postoperatif patoloji uyumu incelendiğinde; nodülün X düzlemdeki boyutu için eşik değer 27 mm olarak bulundu (p<0.001). X ≤ 27 mm olan nodüllerde İİAB nin Sensivite 0.842, Yanlış prediktif değer 0.636 ve Yanlış Negatif Oran (FNR) 0.157 daha anlamlı bulundu. X ≤ 27 mm boyutta; yaş ortalaması, nodül X boyutu ve iki boyutlu alan (X*Y) benign grupta (p<0.001); X ≤ 27 mm ve X tüm boyutta hipoekoik ve mikrokalsifikasyon özelliği malign grupta, İzoekoik görünüm benign grupta anlamlı yüksek bulundu.
Sonuç: Yaş, nodül boyutu ve iki boyutlu alan artışıyla malignite riskinin azaldığı; hipoekojenite ve mikrokalsifikasyon bulgusunun malignite riskini arttırdığı; >27 mm nodüllerde İİAB nin sensivitesinin azaldığı ve false negatif değerinin arttığı görüldü.

Anahtar Kelimeler

İnce iğne aspirasyon biyopsisi, tiroid nodülü, ROC analizi, ultrasonografi

Etik Beyan

Etik kurallara uygun olarak yapılmıştır.

Destekleyen Kurum

yok

The Effect of Thyroid Nodule Size and Characteristics on the Accuracy of Fine-Needle Aspiration Biopsy and the Risk of Malignancy

Öz

Objective: Ultrasound evaluation of nodule characteristics and FNAB is a simple, cost-effective method. However, its reliability in large nodules is controversial. This study aims to examine the impact of thyroid nodule size and characteristics on malignancy risk and FNAB accuracy as evaluated by ultrasound.
Material and Method: This retrospective study included 522 patients who underwent thyroidectomy between January 1, 2020, and January 1, 2024. The data included the patients’ age, gender, preoperative thyroid ultrasound findings, preoperative FNAB pathology findings, operation notes, and postoperative pathology results colleected from hospital archives. Kruskal-Wallis Variance Analysis, ROC (Receiver Operating Characteristics) curve analysis, Bonferroni Corrected Mann-Whitney U Test, Chi-Square Tests, were used at statistical analysis.
Results: The median age was 49.45 years. The threshold value for nodule size in the X plane was 27 mm (p<0.001) when comparing preoperative FNAB with postoperative pathology. For nodules with X ≤ 27 mm, FNAB sensitivity was 0.842, the false predictive value was 0.636, and the false negative rate was 0.157. In this group, the mean age, nodule size, and two-dimensional area (X*Y) were significantly higher nodules, while isoechoic features were more common in benign nodules.
Conclusion: It was found that the risk of malignancy decreases with increasing age, nodule size, and two-dimensional area; the risk of malignancy increases with hypoechoic and microcalcification findings; and FNAB sensitivity decreases and the false negative value increases in nodules >27 mm.

Anahtar Kelimeler

Fine-Needle aspiration biopsy, thyroid nodule, ROC analysis, ultrasound

Kaynakça

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