Accuracy of ultrasound-guided fine-needle aspiration cytology in evaluation of thyroid nodules using different ultrasonographic and cytological features

IF 1.2 4区医学 Q4 CELL BIOLOGY

Cytopathology Pub Date : 2024-07-13 DOI:10.1111/cyt.13420

Fayed Al-Yousofy, Mukhtar Hamood, Abdullah M. Almatary, Abdullatif Mothanna, Saleh Al-Wageeh, Saeed T. Nasher, Ammar Alselwi, Huda Hassan, Anwer Al-Yousofy, Radwan H. Ahmad

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引用次数: 0

Abstract

Background

Fine-needle aspiration cytology (FNAC) is a reliable method for preoperative evaluation of thyroid nodules particularly if ultrasound-guided (USG-FNAC). The main purpose of this study is to evaluate the efficacy of USG-FNAC and its accuracy.

Methods

We retrospectively studied 212 thyroidectomy cases with preoperative ultrasonography and FNAC data during the period 2015–2022 using TI-RADS for final ultrasound diagnosis and Bethesda system for cytological diagnosis.

Results

The studied cases were 200 females and 12 males. Thyroid cancer was more prevalent under 20 years old (78.5%). Papillary thyroid carcinoma comprises 84% of all cancer cases. Significant ultrasound features (p-value <0.05) favour malignancy were hypoechogenicity (66%), mixed echogenicity (84%), irregular border (61%), microcalcification (68%) and rim halo (63.6%). Malignancy was found in 21% of TI-RADS-2, 65% of TI-RADS-4 and 100% of TI-RADS-5. There is a significant difference between different categories of Bethesda system. All cases in Cat-VI were malignant (100%). Malignancy was also found in 81% of Cat-V, 20% of Cat-IV, 33% of Cat-III, 16% of Cat-II and 43% of Cat-I. Cytological features consistent with malignancy were as follows: grooving (94%), nuclear irregularities (89%), nuclear pseudoinclusion (89%) and little colloid (82%). In our study, USG-FNAC sensitivity was 83%, specificity 85%, PPV 85%, NPV 83% and accuracy 84%.

Conclusion

Ultrasound features in favour of malignancy in thyroid nodules are hypoechoic or complex echogenicity, irregular border, punctuate calcification and presence of rim halo. Cytological features in favour of malignancy are grooving, nuclear irregularities, nuclear pseudoinclusion and little or absent colloid.

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超声引导下细针穿刺细胞学利用不同的超声和细胞学特征评估甲状腺结节的准确性。

背景：细针穿刺细胞学检查（FNAC）是甲状腺结节术前评估的可靠方法，尤其是在超声引导下（USG-FNAC）。本研究的主要目的是评估 USG-FNAC 的疗效及其准确性：我们回顾性研究了 2015-2022 年间 212 例甲状腺切除术病例的术前超声和 FNAC 数据，使用 TI-RADS 进行最终超声诊断，使用 Bethesda 系统进行细胞学诊断：研究病例中有 200 名女性和 12 名男性。甲状腺癌的发病年龄多在 20 岁以下（78.5%）。甲状腺乳头状癌占所有癌症病例的 84%。重要的超声特征（P值结论：有利于甲状腺结节恶性的超声特征是低回声或复合回声、边界不规则、点状钙化和边缘光环。有利于恶性的细胞学特征是沟纹、核不规则、核假包涵、胶体少或无。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.