Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2022-07-01 Epub Date: 2022-08-04 DOI:10.5144/0256-4947.2022.246
Rafie Alhassan, Noor Al Busaidi, Abdul Hakeem Al Rawahi, Hilal Al Musalhi, Ali Al Muqbali, Prakash Shanmugam, Fatma Ali Ramadhan
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引用次数: 1

Abstract

Background: Fine needle aspiration cytology (FNAC) of the thyroid has been a reliable and cost-effective method for diagnosing thyroid disorders. Since FNAC results are usually operator dependent, there is a compelling need to explore FNAC accuracy among Omanis.

Objective: Describe cytological features of FNAC and assess FNAC accuracy compared to the postsurgical histopathology report.

Design: Retrospective diagnostic accuracy study SETTING: Tertiary care center.

Patients and methods: Our study included adult Omani adult patients with thyroid nodules who underwent FNAC from 2014 to 2017 and had final pathology results for patients who underwent thyroid surgery. The results were classified according to the UK Royal college of Pathologists 'Thy' categories. Accuracy of FNAC was calculated by determining false and true positive and negative results based on histopathology findings.

Main outcome measures: FNAC accuracy (sensitivity and specificity) compared to the postsurgical histopathology.

Sample size: 867 patients with 1359 ultrasound guided FNACs of thyroid nodule; 137 underwent surgery.

Results: The mean age of the 867 patients was 43.7 (13.3) years, with a median of 42 years, and 87.8% were females. Out of 1359 FNACs, 1001 (73.7%) were benign (Thy2), 119 (8.8%) were atypia of undetermined significance or follicular lesion of undetermined significance (Thy3a), 31 (2.3%) were follicular neoplasm or suspicious for a follicular neoplasm (Thy3f), 52 (3.8%) were suspicious for malignancy (Thy4), 55 (4%) were malignant (Thy5), 101 (7.4%) as Unsatisfactory (Thy1). Only 137 patients underwent thyroid surgery, and the FNAC reports were compared with their final histopathology reports. The sensitivity, specificity and total accuracy of FNAC were 80.2%, 98.9% and 89.9%, respectively. The positive and negative predictive values of FNAC were 98.6% and 84.3%, respectively.

Conclusion: Our study findings confirmed that FNAC of the thyroid is a sensitive, specific, and accurate initial tool for the diagnosis of thyroid lesions. Most of the FNACs were benign with a very low malignancy rate. Due to the minimal chance of false negative results and the slow-growing nature of thyroid malignancy, it is important that patients with benign FNAC should have periodic clinical and radiological follow-up.

Limitations: Retrospective design and single-center study, and thyroid nodule size unavailable.

Conflict of interest: None.

甲状腺结节细针穿刺细胞学特征及诊断准确性:阿曼回顾性研究。
背景:甲状腺细针穿刺细胞学(FNAC)已成为诊断甲状腺疾病的一种可靠和经济的方法。由于FNAC结果通常依赖于操作员,因此迫切需要探索阿曼人的FNAC准确性。目的:描述FNAC的细胞学特征,并与术后组织病理学报告比较FNAC的准确性。设计:回顾性诊断准确性研究设置:三级保健中心。患者和方法:我们的研究纳入了2014年至2017年接受FNAC治疗的阿曼成年甲状腺结节患者,并获得了甲状腺手术患者的最终病理结果。研究结果根据英国皇家病理学家学院的Thy分类进行分类。FNAC的准确性是根据组织病理学结果确定假阳性、真阳性和阴性结果来计算的。主要观察指标:FNAC准确性(敏感性和特异性)与术后组织病理学比较。样本量:867例超声引导甲状腺结节FNACs 1359例;137人接受了手术。结果:867例患者平均年龄43.7(13.3)岁,中位年龄42岁,女性占87.8%。在1359例FNACs中,1001例(73.7%)为良性(Thy2), 119例(8.8%)为意义不明的异型或意义不明的滤泡性病变(Thy3a), 31例(2.3%)为滤泡性肿瘤或可疑滤泡性肿瘤(Thy3f), 52例(3.8%)为可疑恶性(Thy4), 55例(4%)为恶性(Thy5), 101例(7.4%)为不满意(Thy1)。只有137名患者接受了甲状腺手术,并将FNAC报告与最终的组织病理学报告进行了比较。FNAC的敏感性为80.2%,特异性为98.9%,总准确度为89.9%。FNAC阳性预测值为98.6%,阴性预测值为84.3%。结论:我们的研究结果证实了甲状腺FNAC是一种敏感、特异、准确的甲状腺病变诊断的初始工具。大多数FNACs为良性,恶性发生率极低。由于假阴性结果的可能性很小,甲状腺恶性肿瘤生长缓慢,因此良性FNAC患者应定期进行临床和放射学随访。局限性:回顾性设计和单中心研究,无法获得甲状腺结节大小。利益冲突: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
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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