Медицинский совет (Aug 2022)
Comparison of the results of puncture biopsies of thyroid nodes and ultrasound stratification of thyroid cancer risks according to the TIRADS system with the results of histological examination
Abstract
Introduction. Puncture fine needle aspiration (FNA) is currently the “gold standard” for morphological verification of thyroid nodules, which determines the further tactics of patient management. Currently, there are no strict ultrasound criteria for the gradation of malignant neoplasms of the thyroid gland. However, in the modern world, the search for minimally invasive methods for verifying thyroid nodules continues. Purpose of the study. The study carried out a comparative analysis of the results of a preoperative cytological study using the Bethesda system in 2017 and the results of ultrasound studies using developed by the American College of Radiology the Thyroid image reporting and data system (TIRADS). Materials and methods. Thyroid cancer risk stratification system with histological studies of the operating material after 2 440 surgical interventions for nodular goiter, carried out on the basis of the center of endocrine surgery of the city clinical hospital named after. F.I. Inozemtsev in the period from 2018 to 2019 year. Results. The sensitivity of the TIRADS system for the TIRADS 5 thyroid malignancy risk score was 100%. The TIRADS 2 thyroid malignancy risk score was observed only in Bethesda II cytological category and does not occur in malignant histological findings. Grade TIRADS 3 occurs only in patients with a benign histological result, but is also seen in Bethesda II, Bethesda IV, and Bethesda V cytology categories. Conclusions. Based on the study, it can be concluded that FNA is inappropriate in patients with a TIRADS 2 thyroid cancer risk. If a TIRADS 5 cancer risk is detected, regardless of the results of a cytological study, the patient should be recommended surgical treatment. If the cancer risk level is TIRADS 3 and the size of the nodules is up to 2.5 cm, it is also possible to refrain from FNA.
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