Diagnostic adequacy of thyroid fine needle aspiration biopsy: a comparative analysis by age and gender

Abstract

Aims: To evaluate the diagnostic success of thyroid fine needle aspiration biopsy (FNAB) across different age and gender groups, and to investigate the effect of aging and sex-related variables on biopsy adequacy. Methods: This retrospective study included 486 patients who underwent thyroid FNAB between 2022 and 2024. Patients were stratified into two age groups (<65 and ≥65 years) and analyzed by gender. Diagnostic outcomes were classified as diagnostic (benign, malignant, atypia) or non-diagnostic. Statistical analyses, including Fisher’s exact and chi-square tests, were applied to determine the significance of differences. Results: The overall diagnostic yield was 81.7%. Patients under 65 years had a significantly higher diagnostic success rate (86.4%) compared to those aged 65 and older (65.5%, p<0.01). Among older patients, diagnostic adequacy was notably lower in males (53.1%) than females (70.5%). The distribution of pathological diagnoses also varied: the atypia rate was higher in the ≥65 group (8.33%), whereas malignancy was slightly more prevalent in younger patients. Gender alone did not significantly influence diagnostic outcomes (p>0.05), but advanced age was associated with reduced adequacy, potentially due to structural tissue changes or technical limitations. Conclusion: The diagnostic performance of thyroid FNAB diminishes significantly with age, especially in elderly male patients. Gender does not appear to be an independent determinant. These findings highlight the need for optimized biopsy strategies in older populations to enhance diagnostic yield.

Keywords

• Thyroid nodule
• biopsy
• fine-needle
• age factors
• gender factors
• diagnostic techniques and procedures
• cytological techniques

Ethical Statement

Ethical Approval The study was conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. Ethics committee approval was obtained from [Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, 2025-05/74]. Informed Consent: Because the study was designed retrospectively, no written informed consent form was obtained from patients Funding The authors received no specific funding for this work. Conflict of Interest The authors declare no conflict of interest related to this study.

Tiroid ince iğne aspirasyon biyopsisinin tanısal yeterliliği: yaş ve cinsiyete göre karşılaştırmalı analiz

Abstract

Amaç: Tiroid ince iğne aspirasyon biyopsisinin (FNAB) farklı yaş ve cinsiyet gruplarında tanısal başarısını değerlendirmek ve yaşlanma ve cinsiyete bağlı değişkenlerin biyopsi yeterliliği üzerindeki etkisini araştırmak. Yöntemler: Bu retrospektif çalışmaya 2022-2024 yılları arasında tiroid FNAB'si yapılan 486 hasta dahil edildi. Hastalar iki yaş grubuna (<65 ve ≥65 yaş) ayrıldı ve cinsiyete göre analiz edildi. Tanısal sonuçlar tanısal (iyi huylu, kötü huylu, atipi) veya tanısal olmayan olarak sınıflandırıldı. Farklılıkların anlamlılığını belirlemek için Fisher's Exact ve ki-kare testleri de dahil olmak üzere istatistiksel analizler uygulandı. Sonuçlar: Genel tanı verimi %81,7 idi. 65 yaş altı hastaların tanısal başarı oranı (%86,4) 65 yaş ve üzeri hastalara kıyasla önemli ölçüde daha yüksekti (%65,5, p<0,01). Yaşlı hastalarda tanısal yeterlilik erkeklerde (%53,1) kadınlardan (%70,5) belirgin şekilde daha düşüktü. Patolojik tanıların dağılımı da çeşitlilik gösteriyordu: atipi oranı ≥65 grubunda daha yüksekti (%8,33), buna karşın malignite genç hastalarda biraz daha yaygındı. Cinsiyet tek başına tanısal sonuçları önemli ölçüde etkilemedi (p>0,05), ancak ileri yaş, potansiyel olarak yapısal doku değişiklikleri veya teknik kısıtlamalar nedeniyle azalmış yeterlilikle ilişkilendirildi. Sonuç: Tiroid FNAB'nin tanısal performansı yaşla birlikte önemli ölçüde azalır, özellikle yaşlı erkek hastalarda. Cinsiyet bağımsız bir belirleyici gibi görünmüyor. Bu bulgular, tanısal verimi artırmak için yaşlı popülasyonlarda optimize edilmiş biyopsi stratejilerine olan ihtiyacı vurgulamaktadır.

Keywords

• Tiroid biyopsisi
• ince iğne aspirasyonu
• yaş
• cinsiyet
• tanısal yeterlilik
• sitopatoloji
• FNAB

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