Comparative estimation of diagnostic informativity of a fine-needle aspiration biopsy and pathomorphological investigation of nodal thyroidal tumors

Abstract

Objective. Comparative estimation of diagnostic informativity of a fine-needle aspiration biopsy (FNAB) and pathohistological investigation of nodal thyroidal tumors. Маterials and methods. Retrospective analysis of the FNAB and the thyroidal pathohistology results was conducted in 171 patients before and after thyroidectomy, performed for nodal thyroidal tumors. Results. In accordance to the FNAB results a benign thyroidal affection was revealed in 131 (76.6%) patients and a malignant one - in 12 (7%). The method sensitivity has constituted 83.3%, and specificity - 98,5%. In 28 (16.4%) patients the FNAB results were uncertain. In 4 (14.3%) of 28 patients while further pathohistological investigation doing, a malignant affection of a thyroid gland was revealed (follicular cancer - in 1, papillary - in 1, follicular form of papillary cancer - in 1, Hurthle-cellular and papillary cancer - in 1). In 24 (85.7%) of 28 patients a benign thyroidal affection was revealed. In this group the FNAB sensitivity have constituted 65-99%, specificity - 98.5%. As a result of pathohistological investigation a benign thyroidal affection in 153 (89.5%) of 171 patients and malignant - in 18 (10.5%) were revealed. Conclusion. In preoperative diagnosis of nodal thyroidal tumors the uncertain FNAB results rate in preoperative diagnosis of nodal thyroid tumors, in accordance to our data, have constituted 16.4%, what restricts possibilities of this method in verification of malignant thyroidal affections. That is why the operation must not be indicated, basing on the FNAB data only, and molecular-genetic markers ought to be analyzed in this group of patients.

Keywords

• thyroid gland; nodal tumors; fine-needle aspiration biopsy; pathomorphological investigation.