An evaluation of the diagnostic efficacy of fine needle aspiration biopsy in patients operated for a thyroid nodular goiter
Received 24 April 2016
Accepted for publication 6 July 2016
Published 22 September 2016 Volume 2016:9 Pages 5819—5823
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Min Li
Dariusz Janczak,1,2 Wiktor Pawlowski,1 Tadeusz Dorobisz,1,3 Dawid Janczak,4 Karolina Dorobisz,5 Michal Lesniak,1 Agnieszka Ziomek,1 Mariusz Chabowski1,2
1Department of Surgery, 4th Military Teaching Hospital, 2Department of Clinical Nursing, Division of Nursing in Surgical Procedures, 3Department of Clinical Basics of Physiotherapy, 4Department of Palliative Care Nursing, Faculty of Health Science, 5Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
Background: Thyroid cancer (TC) comprises 1% of all carcinomas and is the most common malignancy of the endocrine system. The disease is more common in women, with its peak morbidity observed in 40–50-year-old patients. The main risk factors include radiation, iodine deficiency, hereditary background, and genetic mutations. Among all diagnosed thyroid nodules, 5%–30% will evolve into cancer. The gold-standard procedure in the preoperative evaluation of a nodular goiter, apart from ultrasonography, is fine needle aspiration (FNA) biopsy. The FNA biopsy is favored for its simplicity, safety, and high specificity and sensitivity rates.
Aim: The aim of our study was to evaluate the clinical efficacy of FNA based on the patients’ register.
Materials and methods: In the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, 2,133 patients underwent thyroid surgery for thyroid goiter between 1996 and 2015. One hundred and eight cases of TC were diagnosed and of these, 66 patients had a preoperative FNA.
Results: Fourteen FNA biopsies (21%) revealed cancer, all of which were confirmed in the postoperative histopathology, although six cases of FNA-diagnosed cancer revealed a different histological type postoperatively. Eighteen FNA biopsies (27%) were suspected of being malignant. A disturbingly high rate of “benign” FNA biopsies (32 cases; 48%) revealed TC after surgery.
Conclusion: It is of great importance that the quality and quantity of FNA biopsies that are performed have been improved, especially due to the wide adoption of the Bethesda cytological evaluation system. FNA biopsy remains an obligatory and valuable diagnostic tool in thyroid nodules, but it is still insufficient as a standard procedure. A preoperative biopsy should always be related to all the available clinical data in order to provide the best treatment option for each patient individually.
Keywords: thyroid cancer, fine needle aspiration biopsy, goiter, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC)
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