Tiroid Nodülü Tanısında İnce İğne Aspirasyon Biyopsisi Tekrarı Gerekli Midir?

Yıl 2022, Cilt: 12 Sayı: 4, 721 - 727, 28.12.2022

Recayi Capoglu , Zulfu Bayhan , Emre Gönüllü , Mertcan Akçay , Ahmet Tarık Harmantepe , Furkan Kucuk , Hakan Demir

https://doi.org/10.31832/smj.1183637

Öz

Amaç : Günümüzde yapılan bazı tiroid biyopsi sonuçlarında takip mi yoksa tedavi mi konusu halen tartışmalıdır. Hangi özelliklere sahip Tiroid nodüllerinde ameliyat veya takip yapılmasında birden fazla biyopsi yapılmasının tedavideki yerini araştırmayı amaçladık
Yöntem : Bir üçüncü basamak hastanede 2014-2022 yılları arasında Tiroidektomi yapılan olgular retrospektif incelendi. Preoperatif biyopsi ve postoperatif patoloji sonuçları bağımsız değişkenlerle karşılaştırıldı.
Bulgular : Radyolojik TI-RADS sınıflaması yüksek, artmış nodül çapı olan ve ilaçla regüle olan grupta artmış malignite riski görüldü (p < 0.05). Önemi belirsiz atipi grubunda artmış TI-RADS postoperatif malign patolojiyle uyumlu bulundu.
Sonuç : İlk biyopsi sonucu cerrahi açıdan şüpheli olgularda TI-RADS sınıflaması ve nodül çapı tedavi açısından yol gösterici olabilir.

Anahtar Kelimeler

İnce İğne Aspirasyon Biyopsisi, Tiroid Nodülü, Önemi Belirsi Atipi, Tiroidektomi

Kaynakça

• 1. Allen L, Al Afif A, Rigby MH, et al. The role of repeat fine needle aspiration in managing indeterminate thyroid nodules. J Otolaryngol Head Neck Surg. 2019;48(1):16.
• 2. Topstad D, Dickinson JA. Thyroid cancer incidence in Canada: a national cancer registry analysis. CMAJ Open. 2017;53:612-616. 3. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin. 2013;63(1):11-30. 4. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118(4):282-289.
• 5. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J. 2017;6(5):225-237.
• 6. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009;19(11):1159-1165.
• 7. I Wahid F, Fawad Khan S, Ur Rehman H, Ahmad Khan I. Role of fine needle aspiration cytology in diagnosis of solitary thyroid nodules. Iran J Otorhinolaryngol. 2011;23(65):111-118.
• 8. Agrawal S. Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules. J Surg Oncol. 1995;58(3):168-172.
• 9. Hamburger JI. Diagnosis of thyroid nodules by fine needle biopsy: use and abuse. J Clin Endocrinol Metab. 1994;79(2):335-339.
• 10. Bahar G, Braslavsky D, Shpitzer T, et al. The cytological and clinical value of the thyroid "follicular lesion". Am J Otolaryngol. 2003;24(4):217-220.
• 11. Kaliszewski K, Diakowska D, Rzeszutko M, Nowak Ł, Tokarczyk U, Rudnicki J. Atypia and Follicular Lesions of Undetermined Significance in Subsequent Biopsy Result: What Clinicians Need to Know. J Clin Med. 2021;10(14):3082.
• 12. Marin F, Murillo R, Diego C, Jodar E, Acevedo A. The impact of repeat fine-needle aspiration in thyroid nodules categorized as atypia of undetermined significance or follicular lesion of undetermined significance: A single center experience. Diagn Cytopathol. 2021;49(3):412-417.
• 13. Ooi LY, Nga ME. Atypia of undetermined significance/follicular lesion of undetermined significance: Asian vs. non-Asian practice, and the Singapore experience. Gland Surg. 2020;9(5):1764-1787.
• 14. Na DG, Kim JH, Sung JY, et al. Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. Thyroid. 2012;22(5):468-475.
• 15. Nayar R, Ivanovic M. The indeterminate thyroid fine-needle aspiration: experience from an academic center using terminology similar to that proposed in the 2007 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Cancer. 2009;117(3):195-202.
• 16. Hong MJ, Na DG, Baek JH, Sung JY, Kim JH. Cytology-Ultrasonography Risk-Stratification Scoring System Based on Fine-Needle Aspiration Cytology and the Korean-Thyroid Imaging Reporting and Data System. Thyroid. 2017;27(7):953-959.
• 17. Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda System For Reporting Thyroid Cytopathology. Am J Clin Pathol. 2009 Nov;132(5):658-65.
• 18. Gharib h, Papini e, Garber jr, Duick ds, Harrell rm, Hegedüs l, Paschke r, Valcavi r, Vitti p; aace/ace/ame task force on thyroid nodules. Amerıcan assocıatıon of clınıcal endocrınologısts, amerıcan college of endocrınology, and assocıazıone medıcı endocrınologı medıcal guıdelınes for clınıcal practıce for the dıagnosıs and management of thyroıd nodules--2016 update. Endocr Pract. 2016;22(5):622-39.
• 19. Garg S, Naik LP, Kothari KS, Fernandes GC, Agnihotri MA, Gokhale JC. Evaluation of thyroid nodules classified as Bethesda category III on FNAC. J Cytol. 2017;34(1):5-9
• 20. Jeong SH, Hong HS, Lee EH, Cha JG, Park JS, Kwak JJ. Outcome of thyroid nodules characterized as atypia of undetermined significance or follicular lesion of undetermined significance and correlation with Ultrasound features and BRAF(V600E) mutation analysis. AJR Am J Roentgenol. 2013;201(6):854-60