Role of Fine Needle Aspiration Versus Non-Aspiration Cytology In Diagnosis of Thyroid Lesions

Bhavneet Kour, Kuldeep Singh, P. Singh
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Abstract

Background: Fine needle aspiration cytology (FNAC) is the first choice for evaluation of thyroid enlargement. Diagnosis is based on the identification of predominant cell pattern, cell morphology and background details. Fine needle non-aspiration cytology (FNNAC) avoids aspiration, uses capillary action of the fine needle. It is more patient friendly with less pain and better perception of lesion. Aim of the study: To evaluate the results ofFine Needle Aspiration Cytology (FNAC) and Fine Needle Non Aspiration Cytology (FNNAC) in diagnosis of thyroid lesions. Materials and Methods: One-year observational, prospective study was conducted on patients with palpable thyroid lesions in the Department of Pathology, Government Medical College, Jammu. Patients were investigated with a thyroid function test and a needle biopsy. Both FNAC and FNNAC techniques were performed simultaneously at the same site by the same investigator. Points were allocated to each specimen according to Mair et al. scoring system and categorized as follows: unsuitable for cytodiagnosis (0-2 points), diagnostically adequate (3-6 points) and diagnostically superior (7-10 points). Results: A total of 140 patients with palpable thyroid lesions were subjected to needle biopsies. Females dominated the study with female to male ratio of 5.36:1. Non-neoplastic lesions were observed in 89.29% and neoplastic in 10.71% cases. . The cumulative score was found significantly more in case of FNNAC than FNAC (946 vs 784; p<0.0001). For diagnostically superior category, results of both FNAC and FNNAC were comparable. Conclusion: FNAC smears produced adequate results in more cases. FNNAC was more diagnostically superior. It causes less damage to tissue, less artefacts and allows better perception of lesion. FNNAC is a good technique that should be used alone or in combination with FNAC for better diagnostic yield.
细针穿刺与非穿刺细胞学在甲状腺病变诊断中的作用
背景:细针穿刺细胞学检查(FNAC)是评估甲状腺肿大的首选方法。诊断是基于显性细胞模式,细胞形态和背景细节的识别。细针非抽吸细胞学(FNNAC)避免抽吸,利用细针的毛细管作用。它对病人更友好,疼痛更少,病变感觉更好。目的:探讨细针穿刺细胞学(FNAC)与细针非穿刺细胞学(FNNAC)在甲状腺病变诊断中的价值。材料与方法:对查谟政府医学院病理科可触及甲状腺病变患者进行为期一年的观察性前瞻性研究。对患者进行甲状腺功能检查和穿刺活检。FNAC和FNNAC技术由同一研究者在同一部位同时进行。根据maair等评分系统对每个标本进行评分,分为不适合细胞诊断(0-2分)、诊断适宜(3-6分)和诊断优良(7-10分)。结果:140例可触及甲状腺病变患者行针活检。以女性为主,男女比例为5.36:1。非肿瘤性病变占89.29%,肿瘤性病变占10.71%。FNNAC的累积得分明显高于FNAC (946 vs 784;p < 0.0001)。对于诊断优势类别,FNAC和FNNAC的结果具有可比性。结论:FNAC涂片在更多病例中获得了足够的结果。FNNAC在诊断上更优越。它对组织造成的损伤更小,人工制品更少,并且可以更好地感知病变。FNNAC是一种很好的技术,可单独使用或与FNAC联合使用,以提高诊断率。
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