Fine-needle Aspiration Biopsy for Diagnosis of Nodular Thyroid Disease

Yıl 2001, Cilt: 2 Sayı: 1, 21 - 26, 01.04.2001

Fazıl Serdar Gürel

Öz

The purpose of this study is to asses the diagnostic value of fine needle aspiration biopsy and its role in
deciding for surgery.
Cytological results, obtained by fine needle aspiration biopsy (FNAB) and the
histopathological results of 87 patients with nodular thyroid disease who were operated on were reviewed and
compared. The cytological results of FNAB were grouped as either malignant, suspicious of malignancy, benign
or insufficient material. Histopathological results were grouped as either malignant or benign. The false negative,
false positive, true negative and true positive results were calculated. Sensitivity, specificity and accuracy were
determined by using Galen and Gambino method.
Sensitivity, specificity and accuracy of FNAB were %85,7, %94.5 and %93.75 respectively. The
positive predictive value was %60 and negative predictive value was %98.5. The percentage of false negative
results was %1.25 and false positive results was %5.
FNAB has a high rate of accuracy in the preoperative evaluation of thyroid nodules. It is a simple
and cost-effective diagnostic tool. The rate of correct diagnosis could increase and the number of unnecessary
thyroid operations could decrease further when the clinician and cytopathologist have more experience with
FNAB

Anahtar Kelimeler

fine needle aspiration biopsy, nodular thyroid disease, thyroid cancer

Kaynakça

• 1. Rojeski MT, Gharib H. Nodular Thyroid Disease. Evaluation and management. N Engl J Med 1985; 313: 428-36.
• 2. Mazzaferi EL, de los Santos ET, Rofagha-Keyhani S. Solitary thyroid nodule: diagnosis and management. Med Clin North Am 1988; 72: 1177- 211.
• 3. Sadler GP, Clark OH, VanHeerden JA, Farley DR. Thyroid and parathyroid. In: Principles of Surgery 7 ed. Ed. Schwartz, Spencer, Shires. Newyork, Mc Graw Hill Inc 1999;1661-1713.
• 4. Wools MS. Evaluation of thyroid nodules. In: Surgery of the thyroid and parathyroid glands. 3th ed. Candy B, Rossi RL. Philadelphia WB Saunders Company 1991:83-91
• 5. Silverman JF, West RL, Larkin EW, Finley JL. The role of fine-needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm. Cancer 1986;57:1164-70
• 6. Gharib H, Goeliner JR. Fine needle aspiration biopsy of the Thyroid. An appraisal. Ann Intern Med 1993;118:282-89.
• 7. Kýlýçturgay S, Özgüç H, Ýrgil C, Sadýkoðlu Y, Yerci Ö, Bilgel H. Tiroid nodüllerinde ince iðne aspirasyon biyopsisi ve cerrahi karara etkisi. Ulusal Cerrahi Dergisi 1993; 9:260-267.
• 8. Özgüç H, Korun N, Yýlmazlar T, Ýrgil C, Tuncel E, Yerci Ö. Tiroid karsinomu:51 olgunun retrospektif analizi. Ulusal Cerrahi Dergisi 1995; 11:170-179.
• 9. Goeliner JR, Gharib H, Grant CS, Jhonson DA. Fine needle aspiration cytology of thyroid, 1980 to 1986. Acta Cytologica 1987; 31:587-90,.
• 10. Gharib H, Goellner JR, Zinsmeister AR, Grant CS, Van Heerden JA. Fine needle aspiration biopsy of Thyroid. The problem of suspicious cytologic findings. Ann Intern Med 1984; 101:25-8.
• 11. Galen RS, Gambino SR. Beyond normality. In:The predictive value and efficiency of medical diagnosis. New York. JohnWiley and Sons 1975:10-14.
• 12. Miller JM. Evaluation of thyroid nodules. Accent on needle biopsy. Med Clin North Am 1985; 69:1063-77.
• 13. Gharib H, Goellner JR, Johnson DA. Fine needle aspiration cytology of the thyroid. A 12-year experience with 11000 biopsies. Clin Lab Med 1993; 13:699-709.
• 14. Hanni CL, Bratl HJ, Dean RE, Vanvliet PD. Fine needle aspiration biopsy; A reliable diagnostic tool in the management of thyroid nodules. Am J Surg 1984; 50:485-87.
• 15. Gardiner GW, de Souza FM, Carydis B, Seemann C. Fine needle aspiration biopsy of the thyroid gland:results of a five year experience and discussion of its clinical limitations. J Otolaryngol 1986; 15:161- 5.
• 16. Hawkins F, Bellido D, Bernal C, Rigopoulou D, Ruiz Valdepenas MP, Lazaro E. Fine needle aspiration biopsy in the thyroid cancer and thyroid disease. Cancer 1987; 59:1206-9.
• 17. Khafagi F, Wright G, Castles H, Perry-Keene D, Mortimer R. Screening of thyroid malignancy: the role of fine-needle biopsy. Med J Aust 1988; 149:302- 3,306-7.
• 18. Caplan RH, Strutt PJ, Kisken WA, Wester SM. Fine needle aspiration biopsy of thyroid nodules. Wis. Med. J 1991; 90:285-8.
• 19. Burch HB, Burman D, Reed L. Fine needle aspiration of thyroid nodules. Acta Cyto 1996; 40:1176-83.
• 20. de los Santos ET, Keyhani-Gofogha S, Cunningham JJ. Cystic thyroid nodules. The dillemma of malignant lesions. Arch Intern Med 1990; 150:1422-7.
• 21. Hall TL, Layfield LJ, Phlippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer 1989; 63:718-25.
• 22. Chang HY, Lin JD, Chen JF, Hsueh C, Jeng LB, Tsai JS. Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules. J Clin Pathol 1997; 50:1005-9.
• 23. Bakhos R, Selvaggi SM, De Jong S, Gordon DL, Pitale SU;Herrmann M, Wojcik EM. Fine-needle aspiration of the thyroid: rate and causes of cytopathologic discordance. Diagn Cytopathol 2000; 23:233-7.
• 24. Borman KR, Hume AT. Credibility and clinical utility of thyroid fine-needle aspiration biopsy in a teaching hospital. Am J Surg 1995; 170:638-41.
• 25. Altavilla G, Pascale M, Nenci I. Fine needle aspiration cytology of thyroid gland disease. Acta Cytol 1990; 34:251-6.
• 25. Miller JM, Hamburger JI, Kini SR. The impact of needle biopsy on the preoperative diagnosis of thyroid nodules. Henry Ford Hosp. Med J 1980; 5:185-99.
• 26. Hamberger B, Gharib H, Melton LJ, Goelner JR, Zinsmeister AR. Fine needle aspiration biopsy of thyroid nodules. Impact on thyroid practice and cost of care. Am J Med 1982; 73:381-4.
• 27. Van Herle AJ, Rich P, Ljung B, Ascraft MW, Solomon DH, Keeler EB. The thyroid nodule. Ann Intern Med 1982; 96:221-32.
• 28. Haas S, Trujýllo A, Kunstle J. Fine needle aspiration of thyroid nodules in rural setting., Am J. Med 1993; 94:357-61.