Hypoechoic nodule structure increases non-diagnostic rate of thyroid fine needle aspiration biopsy

Yıl 2021, , 886 - 891, 24.09.2021

Zeynep Çetin

https://doi.org/10.32322/jhsm.976299

Öz

Aim: Thyroid fine needle aspiration biopsy (FNAB) performed with ultrasonography is an effective method in diagnosing thyroid cancer. Nevertheless, some of them have non-diagnostic results. The aim is to investigate the factors that affect non-diagnostic result.
Material and Method: FNABs of 361 nodules of 361 patients were analyzed retrospectively. The patients were divided into two groups as fine needle aspiration biopsy result with and without non-diagnostic. The groups were compared according to demographic, clinical and sonographic data.
Results: Non-diagnostic rate was 14.4% in all biopsies. There was no difference in terms of age, gender, previous thyroid surgery history, smoking history, aspirin use, Hashimoto’s thyroiditis, toxic nodule. Sonographic findings of the thyroid glands and nodules were similar. Only the echogenicity of the nodule was found to affect the non-diagnostic result (p=0.015). In the post hoc analysis, the difference was found to be caused by hypoechoic nodules (32.7% versus 15.5). It was observed that the significant relationship found in univariate logistic regression analysis (p=0.009, OR: 3.227, CI: 1.334-7.803) continued in multivariate analysis (p=0.024, OR: 3.175, CI: 1.163-8.668).
Conclusion: Only hypoechoic echogenicity increases the risk of non-diagnostic rate. Other factors do not increase the non-diagnostic rate.

Anahtar Kelimeler

Thyroid fine needle aspiration biopsy, ultrasonography, non-diagnostic, hypoechogenicity

Proje Numarası

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Kaynakça

• Le AR, Thompson G, Hoyt BJ. Thyroid Fine-needle aspiration biopsy: an evaluation of its utility in a community setting. J Otolaryngol Head Neck Surg 2015; 44: 12-6.
• Huang LY, Lee YL, Chou P, Chiu WY, Chu D. Thyroid fine-needle aspiration biopsy and thyroid cancer diagnosis: a nationwide population-based study. PLoS ONE 2015; 10: e0127354.
• Olson MT, Zelger MA. Thyroid fine-needle aspiration and cytological diagnosis. In: Jameson JL, De Groot LJ, editors. Endocrinology adult and pediatric. 7th edition Philadelphia: Elsevier Saunders 2016: 1417-22.
• Ali SZ, Cibas ES. The Bethesda system for reporting thyroid cytopathology. definitions, criteria and explanatory notes. New York-USA: Springer, 2010.
• Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol 2012; 56: 333–9.
• Luu MH, Fischer AH, Pisharodi L, Owens CL. Improved preoperative definitive diagnosis of papillary thyroid carcinoma in FNAs prepared with both ThinPrep and conventional smears compared with FNAs prepared with ThinPrep alone. Cancer Cytopathol 2011; 119: 68–73.
• Moon HJ, Kwak JY, Choi YS, Kim EK. How to manage thyroid nodules with two consecutive nondiagnostic results on ultrasonography-guided fine-needle aspiration. World J Surg 2012: 586–92.
• Inci MF, Ozkan F, Yuksel M, Salk I, Sahin M. The effects of sonographic and demographic features and needle size on obtaining adequate cytological material in sonographyguided fine-needle aspiration biopsy of thyroid nodules. Endocrine 2013; 43: 424–9.
• Khan TS, Sharma E, Singh B, et al. Aspirin Increases the Risk of Nondiagnostic Yield of Fine-Needle Aspiration and Biopsy of Thyroid Nodules. Eur Thyroid J 2018; 7: 129–32.
• Ziemiańska K, Kopczyński J, Kowalska A. Repeated nondiagnostic result of thyroid fine-needle aspiration biopsy. Contemp Oncol (Pozn) 2016; 20: 491–5.
• Shabana W, Peeters E, Verbeek P, Osteaux MM. Reducing intraobserver variation in thyroid volume calculation using a new formula and technique. Eur J Ultrasound 2003; 16: 207-10.
• Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. THYROID 2016; 26: 1-133.
• Penín M, Martín MA, Millán BS, Garcia J. Learning curve of thyroid fine-needle aspiration biopsy. Endocrinol Diabetes Nutr 2017; 64: 539-43.
• Ozel D, Ozel BD, Ozkan F. Potential causes for obtaining non‑diagnostic results from fine needle aspiration biopsy of thyroid nodules. Radiol Med 2016; 121: 510–4.
• Gutaj, NS, Ziółkowska P, Sowiński J. Recurrent goiter: risk factors, patient quality of life, and efficacy of radioiodine therapy. Pol Arch Intern Med 2019; 129: 22-27.
• Onal ED, Saglam F, Sacikara M, Ersoy R, Guler G, Cakır B. The diagnostic accuracy of thyroid nodule fine-needle aspiration cytology following thyroid surgery: a case–control study. Endocr Pathol 2014; 25: 297–301.
• Cho YA, Kim J. Thyroid cancer risk and smoking status: a meta-analysis. Cancer Causes Control 2014; 25: 1187–95.
• Kim SJ, Kim MJ, Yoon SG, et al. Impact of smoking on thyroid gland: dose-related effect of urinary cotinine levels on thyroid function and thyroid autoimmunity. Sci Rep 2019; 9: 1–6.
• Karatoprak C, Kartal I, Kayatas K. Does smoking affect thyroid gland enlargement and nodule formation in iodine-sufficient regions? Ann Endocrinol (Paris) 2012; 73: 542-5.
• Wu G, Zou D, Cai H, Liu Y. Ultrasonography in the diagnosis of Hashimoto’s thyroiditis. Front Biosci (Landmark Ed) 2016; 21: 1006-12.
• Meng C, Hinkle, LE, Wang W, Su D, Li X. Hashimoto’s thyroiditis elicits decreased diagnostic efficacy of thyroid nodule ultrasound-guided fine needle aspiration. Int J Clin Exp Pathol 2019; 12: 3474-82.
• Gao L, Ma B, Zhou L. The impact of presence of Hashimoto's thyroiditis on diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy in subcentimeter thyroid nodules: a retrospective study from FUSCC. Cancer Med 2017; 6: 1014-22.
• Smitt JJ, Chen X, Schneider DF. Toxic nodular goiter and cancer: a compelling case for thyroidectomy. Ann Surg Oncol 2016; 20: 1336-40.
• Baser H, Topaloglu O, Bilginer MC. Are cytologic and histopathologic features of hot thyroid nodules different from cold thyroid nodules? Diagn Cytopathol 2019; 47: 898-903.
• Moon HJ, Kwak JY, Kim EK, Kim MJ. Ultrasonographic characteristics predictive of nondiagnostic results for fine-needle aspiration biopsies of thyroid nodules. Ultrasound Med Biol 2011; 37: 549-55.
• Chen SJ, Yu SN, Tzeng JE, et al. Characterization of the major histopathological components of thyroid nodules using sonographic textural features for clinical diagnosis and management. Ultrasound Med Biol 2009; 35: 201– 8.
• Degirmenci B, Haktanir A, Albayrak R, et al. Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material. Clin Radiol 2007; 62: 798–803.
• Choi YS, Hong SW, Kwak JY, Moon HJ, Kim EK. Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. Ann Surg Oncol 2012; 19: 2304–09.