Diagnostic accuracy of fine needle aspiration biopsy for detection of malignancy in thyroid nodules in Somdet Phra Phuttha Loetla Hospital
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Published:
Mar 1, 2020
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Abstract
Objectives: To determine the predictive value of FNA in thyroid nodule compared with surgical pathology, and to determine the histopathological cell types of thyroid nodule.
Materials and Methods: The study was conducted by reviewing cases of patients diagnosed with thyroid nodule by otolaryngologist in Somdet Phra Phuttha Loetla Hospital, since January 1, 2015 to July 31, 2019
Results: One hundred and thirty-nine patients were included, of which 88.49 were female. The average age was 48 years old (x = 48.09, SD=16.14). A total of 93.52 % were solitary nodule and the average size was 4.83 cm in diameter. The result of FNA revealed 22.3 % of malignancy The positive predictive value, negative predictive value, accuracy rate, sensitivity, and specificity of FNA in thyroid nodule were 91.18, 91.43, 91.37, 77.5, and 96.97, respectively.
Conclusion: The predictive value, accuracy rate, sensitivity, and specificity of FNA for thyroid nodule in Somdet Phra Phuttha Loetla Hospital are similar to those of other institutions. The result of pathology revealed 28.78 % of malignancy, which was found more in male patients than in female patients (the ratio was 2:1). The most common malignancy in thyroid nodules was papillary carcinoma. FNA can be used as a reference for management the cases of thyroid nodule in Somdet Phra Phuttha Loetla Hospital. This FNA biopsy is simple, rapid, inexpensive, and is a harmless procedure.
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นิพนธ์ต้นฉบับ (Original Article)
References
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4. Settakorn J, Chaiwan B, Thamprasert K, Wisedmongkol W, Rangdaeng S. Fine needle aspiration of the thyroid gland. J Med Assoc Thai. 2001; 84(10): 1401-6.
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9. Goldman ND, Coniglio JU, Falk SA, Thyroid cancers. I. Papillary, follicular, and Hürthle cell. Otolaryngol Clin of North Am. 1996;29(4):593-609.
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12. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology. 1991;181(3): 683-7.
13. Walsh RM, Watkinson JC, Franklyn J, The management of the solitary thyroid nodule: a review. Clin Otolaryngol Allied Sci. 1999;24(5):388-97.
14. Welker MJ, Orlov D. Thyroid Nodules. Am Fam Physician. 2003; 67(3):559-66.
15. Franklyn JA, Daykin J, Young J, Oates GD , Sheppard MC. Fine needle aspiration cytology in diffuse or multinodular goiter compared with solitary thyroid nodular. BMJ. 1993;307(6898):240.
16. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid gland. CT and MR imaging and correlation with pathology and clinical finding. Radiol Clin North Am. 2000;38(5):1105-29.
17. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930;92(2):169-81.
18. Hopald KH, Layfield LJ, Mohrmann R, Foshag LJ, Giuliano AE. Clarifying the role of fine-needle aspiration cytology evaluation and frozen section in operative management of thyroid cancer. Arch Surg. 1989; 124(10):1201-5.
19. Boyd LA, Earnhardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules. J Am Coll Surg. 1998;187(5): 494-502.
20. Keller MP, Crabbe MM, Norwood SH. Accuracy and significance of fine-needle aspiration and frozen section in determining the extent of thyroid resection. Surgery. 1987 May;101(5):632-5.
21. Himakoun L, Kanjanavirojkul N, Vatanasapt V, Jaroensiri DJ, Aranyasen O. Fine needle aspiration cytologic diagnosis of the thyroid nodule in Srinagarind hospital. Srinagarind Hosp Med. J 1991;6(4):243-51.
22. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al.; American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16(2):109-42.
23. Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, Wiersinga W. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium . Eur J Endocrinol. 2006;154(6):787-803.
24. Chang HY, Lin JD, Chen JF, Huang BY, Hsueh C, Jeng LB, et al. Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules. J Clin Pathol. 1997;50(12):1005-9.
25. Charies MA, Haller KS. Cytologic determinants of well-differentiated thyroid cancer. Am J Surg. 1997;174(5):545-7.
26. Cheung YS, Poon CM, Mak SM, Suen MW, Leong HT. Fine-needle aspiration cytology of thyroid nodules-how well are we doing? Hong Kong Med J. 2007;13(1): 12-5.
27. Chokuchitchai S. Fine Needle Aspiration Biopsy in Patients with Solitary Thyroid Nodule in Ayutthaya Hospital. Phra Nakhon Si Ayutthaya Med J. 2002;4(1): 2-8 .
28. Hall TL, Layfield LJ, Phillippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer. 1989;63(4):718-25.
29. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118(4):282-9.
30. Leonard N, Melcher DH. To operate or not to operate? The value of the needle aspiration cytology in the assessment of thyroid swelling. J Clin Pathol. 1997;50(11):941-3.
31. Goellner JR, Grarib H, Grant CS, Johnson DA. Fine needle aspiration cytology of the thyroid, 1980 to 1986. Acta Cyto. 1987;31(5):587-90.
32. Gharib H, Goeliner JR. Fine needle aspiration cytology of thyroid nodule. Endocr Pract. 1995;1(6):410-7.
33. Castro MR, Grarib H. Fine-needle aspiration biopsy: progress, practice,and pitfalls. Endocr Pract. 2003;9(2):128-36.
34. Mazeh H, Beglaibter N, Prus D, Ariel I, Freund HR. Cytohistologic correlation of thyroid nodules. Am J Surg. 2007;194(2):161-3.
35. Gharib H. Fine-needle aspiration biopsy of thyroid nodule: advantage, limitations and effect. Mayo Clin Proc. 1994; 69(1):44-9.
36. Smith J, Cheifetz RE, Schneidereit N, Berean K, Thomson T. Can cytology accurately predict benign follicular nodules? Am J Surg. 2005;189(5):592-5.
37. Tuttle RM, Lemar H, Burch HB. Clinical features associated with an increased risk of thyroid malignancy in patients with follicular neoplasia by fine-needle aspiration. Thyroid. 1998:8(5)377-383.
38. Rifast SF, Ruffin MT 4th. Management of thyroid nodules. Am Physician. 1994;50(4):785-90.
39. Kumar H, Daykin J, Holder R, Watkinson JC, Sheppard MC, Franklyn JA, Gender, Clinical findings, and serum thyrotropin measurements in the prediction of thyroid neoplasia in 1005 patients presenting with thyroid enlargement and investigated by FINE-NEEDLE ASPIRATION cytology. Thyroid. 1999;9(11):1105-9.
40. Juntakul V. Solitary thyroid nodule in Songkhal hospital.Thailand. Songkla Med J. 1998; 9(4):25-8.
41. Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ J Surg. 2003;73(7):408-3.
42. Lopez LH, Canto JA, Herrera MF, Gamboa-Dominguez A, Rivera R, Gonzalez O, et al. Efficacy of fine–needle aspiration biopsy of thyroid nodule: experience of Mexican institution. Word J Surg. 1997;21(4):408-11.
43. Godinho-Matos L, Kocjan G, Kurtz A. Contribution of fine needle aspiration cytology to diagnosis and management of thyroid disease. J Clin Pathol. 1992;45(5):391-5.
44. Rosen IR, Azadian A, Walfish PG, Salem S, Landsdown E, Bedard YC. Ultrasound-guided fine-needle aspiration biopsy in the management of thyroid disease. Am J Surg. 1993;166(4): 326-9.
45. Holleman F1, Hoekstra JB, Ruitenberg HM. Evaluation of fine needle aspiration (FINE-NEEDLE ASPIRATION) cytology in the diagnosis of thyroid nodules. Cytopathology. 1995;6(3):168-75.
46. Ogawa Y, Kato Y, Ikeda K, Aya M, Ogisawa K, Kitani K, et al. The value of ultrasound-guided fine-needle aspiration cytology for thyroid nodules: an assessment of its diagnostic
47. potential and pitfalls. Surg Today. 2001;31(2):97-101.
48. Suraseang K. Diagnostic performance of fine needle aspiration biopsy among thyroid gland neoplasms. 6/2 Region Medical Journal. 2004;12(1): 28-35
49. Rechaipichikul W, Suetrong, Prakunhungsit, Kulpradittaom, Jiamjunya. The Management of Thyroid mass: A seven - year experience at Ramathibodi Hospital. Khon Kaen Hospital Medical Journal. 1999;23(2):80-91.
50. Chealchan J. Diagnostic accuracy of thyroid nodule by fine-needle aspiration in Uthaithani hospital. Sawanpracharak Medical J. 2004;1(3): 182-8.
51. Tangsathitporn R. Clinical and pathological characteristics of solitary thyroid nodules in Trang hospital. Songkla Med J. 2011;29(2): 65-75.
52. Vajrabukka T, Sapasiraporn W. Management of solitary thyroid nodule. Chula Med J. 2004;48(3): 191-212.
53. Flanagan MB, Ohori NP, Carty SE, Hunt JL. Repeat thyroid nodule fine needle aspiration in patient with initial benign cytologic result. Am J Clin Pathol. 2006;125(5): 698-702.
54. Gharib H, Mazzaferri EL. Thyroxine suppressive therapy in patient with nodular thyroid disease. Ann Intern Med. 1998;128(5):386-94.
55. Busseniers AE, Oertel YC. “Cellular adenomatoid nodules” of the thyroid: Review of 219 fine needle aspiration. Diagn Cytopathol. 1993;9(5):581-9.
56. Tsang K, Duggan MA. Vascular proliferation of the thyroid. A complication of fine-needle aspiration. Arch Pathol Lab Med. 1992;116(10):1040-1042.
57. Roh JL. Intrathyroid hemorrhage and acute upper airway obstruction after fine needle aspiration of the thyroid gland. Laryngoscope. 2006;116(1):154-156.
58. Noordzij JP, Goto MM. Airway compromise caused by hematoma after thyroid fine-needle aspiration. Am J Otolaryngol. 2005;26(6):398-399.
2. Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid. Arch Pathol Lab Med. 2001;125(4):484-8.
3. Damrongvadha P. Solitary thyroid nodule. J Med Ass Thai. 1985; 68(6): 288-92.
4. Settakorn J, Chaiwan B, Thamprasert K, Wisedmongkol W, Rangdaeng S. Fine needle aspiration of the thyroid gland. J Med Assoc Thai. 2001; 84(10): 1401-6.
5. Mazzaferri EL. Thyroid cancer in thyroid nodular: Finding a needle in the haystack. Am J Med. 1992; 93(4): 359-62.
6. Giles GG, Thursfield V. Cancer in Victoria 1999. CANSTAT No. 34. Melbourne: Anti-Cancer Council of Victoria;2001.
7. Rojeski MT, Gralib H. Nodular thyroid disease. Evaluation and management. N Engl J Med. 1985;313(7):428-36.
8. Intamakul N. Management and analysis 459 cases of thyroid nodule in ENT, Central Hospital. Otolaryngol Thai J. 1993;1(1): 17-22.
9. Goldman ND, Coniglio JU, Falk SA, Thyroid cancers. I. Papillary, follicular, and Hürthle cell. Otolaryngol Clin of North Am. 1996;29(4):593-609.
10. Pickle LW, Manson TJ, Howard N, Hoower R, Fraumeni JF Jr. Atlas of U.S. cancer mortality among Whites: 1950-1980. Bethesda, Maryland: U.S. Department of Health and Human services, Public Health Services, Nation Institutes of Health; DHHS Publication No.(NIH) 87-2900;1987. P. 177.
11. Sriplung H, Sontipong S, Martin N, Wiangnon S, Vootiprux V, Cheirsilpa A, et al. Cancer incidence in Thailand, 1995-1997. Asian Pac J Cancer Prev. 2005;6(3):276-81.
12. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology. 1991;181(3): 683-7.
13. Walsh RM, Watkinson JC, Franklyn J, The management of the solitary thyroid nodule: a review. Clin Otolaryngol Allied Sci. 1999;24(5):388-97.
14. Welker MJ, Orlov D. Thyroid Nodules. Am Fam Physician. 2003; 67(3):559-66.
15. Franklyn JA, Daykin J, Young J, Oates GD , Sheppard MC. Fine needle aspiration cytology in diffuse or multinodular goiter compared with solitary thyroid nodular. BMJ. 1993;307(6898):240.
16. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid gland. CT and MR imaging and correlation with pathology and clinical finding. Radiol Clin North Am. 2000;38(5):1105-29.
17. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Ann Surg. 1930;92(2):169-81.
18. Hopald KH, Layfield LJ, Mohrmann R, Foshag LJ, Giuliano AE. Clarifying the role of fine-needle aspiration cytology evaluation and frozen section in operative management of thyroid cancer. Arch Surg. 1989; 124(10):1201-5.
19. Boyd LA, Earnhardt RC, Dunn JT, Frierson HF, Hanks JB. Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules. J Am Coll Surg. 1998;187(5): 494-502.
20. Keller MP, Crabbe MM, Norwood SH. Accuracy and significance of fine-needle aspiration and frozen section in determining the extent of thyroid resection. Surgery. 1987 May;101(5):632-5.
21. Himakoun L, Kanjanavirojkul N, Vatanasapt V, Jaroensiri DJ, Aranyasen O. Fine needle aspiration cytologic diagnosis of the thyroid nodule in Srinagarind hospital. Srinagarind Hosp Med. J 1991;6(4):243-51.
22. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al.; American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16(2):109-42.
23. Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, Wiersinga W. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium . Eur J Endocrinol. 2006;154(6):787-803.
24. Chang HY, Lin JD, Chen JF, Huang BY, Hsueh C, Jeng LB, et al. Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules. J Clin Pathol. 1997;50(12):1005-9.
25. Charies MA, Haller KS. Cytologic determinants of well-differentiated thyroid cancer. Am J Surg. 1997;174(5):545-7.
26. Cheung YS, Poon CM, Mak SM, Suen MW, Leong HT. Fine-needle aspiration cytology of thyroid nodules-how well are we doing? Hong Kong Med J. 2007;13(1): 12-5.
27. Chokuchitchai S. Fine Needle Aspiration Biopsy in Patients with Solitary Thyroid Nodule in Ayutthaya Hospital. Phra Nakhon Si Ayutthaya Med J. 2002;4(1): 2-8 .
28. Hall TL, Layfield LJ, Phillippe A, Rosenthal DL. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer. 1989;63(4):718-25.
29. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118(4):282-9.
30. Leonard N, Melcher DH. To operate or not to operate? The value of the needle aspiration cytology in the assessment of thyroid swelling. J Clin Pathol. 1997;50(11):941-3.
31. Goellner JR, Grarib H, Grant CS, Johnson DA. Fine needle aspiration cytology of the thyroid, 1980 to 1986. Acta Cyto. 1987;31(5):587-90.
32. Gharib H, Goeliner JR. Fine needle aspiration cytology of thyroid nodule. Endocr Pract. 1995;1(6):410-7.
33. Castro MR, Grarib H. Fine-needle aspiration biopsy: progress, practice,and pitfalls. Endocr Pract. 2003;9(2):128-36.
34. Mazeh H, Beglaibter N, Prus D, Ariel I, Freund HR. Cytohistologic correlation of thyroid nodules. Am J Surg. 2007;194(2):161-3.
35. Gharib H. Fine-needle aspiration biopsy of thyroid nodule: advantage, limitations and effect. Mayo Clin Proc. 1994; 69(1):44-9.
36. Smith J, Cheifetz RE, Schneidereit N, Berean K, Thomson T. Can cytology accurately predict benign follicular nodules? Am J Surg. 2005;189(5):592-5.
37. Tuttle RM, Lemar H, Burch HB. Clinical features associated with an increased risk of thyroid malignancy in patients with follicular neoplasia by fine-needle aspiration. Thyroid. 1998:8(5)377-383.
38. Rifast SF, Ruffin MT 4th. Management of thyroid nodules. Am Physician. 1994;50(4):785-90.
39. Kumar H, Daykin J, Holder R, Watkinson JC, Sheppard MC, Franklyn JA, Gender, Clinical findings, and serum thyrotropin measurements in the prediction of thyroid neoplasia in 1005 patients presenting with thyroid enlargement and investigated by FINE-NEEDLE ASPIRATION cytology. Thyroid. 1999;9(11):1105-9.
40. Juntakul V. Solitary thyroid nodule in Songkhal hospital.Thailand. Songkla Med J. 1998; 9(4):25-8.
41. Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ J Surg. 2003;73(7):408-3.
42. Lopez LH, Canto JA, Herrera MF, Gamboa-Dominguez A, Rivera R, Gonzalez O, et al. Efficacy of fine–needle aspiration biopsy of thyroid nodule: experience of Mexican institution. Word J Surg. 1997;21(4):408-11.
43. Godinho-Matos L, Kocjan G, Kurtz A. Contribution of fine needle aspiration cytology to diagnosis and management of thyroid disease. J Clin Pathol. 1992;45(5):391-5.
44. Rosen IR, Azadian A, Walfish PG, Salem S, Landsdown E, Bedard YC. Ultrasound-guided fine-needle aspiration biopsy in the management of thyroid disease. Am J Surg. 1993;166(4): 326-9.
45. Holleman F1, Hoekstra JB, Ruitenberg HM. Evaluation of fine needle aspiration (FINE-NEEDLE ASPIRATION) cytology in the diagnosis of thyroid nodules. Cytopathology. 1995;6(3):168-75.
46. Ogawa Y, Kato Y, Ikeda K, Aya M, Ogisawa K, Kitani K, et al. The value of ultrasound-guided fine-needle aspiration cytology for thyroid nodules: an assessment of its diagnostic
47. potential and pitfalls. Surg Today. 2001;31(2):97-101.
48. Suraseang K. Diagnostic performance of fine needle aspiration biopsy among thyroid gland neoplasms. 6/2 Region Medical Journal. 2004;12(1): 28-35
49. Rechaipichikul W, Suetrong, Prakunhungsit, Kulpradittaom, Jiamjunya. The Management of Thyroid mass: A seven - year experience at Ramathibodi Hospital. Khon Kaen Hospital Medical Journal. 1999;23(2):80-91.
50. Chealchan J. Diagnostic accuracy of thyroid nodule by fine-needle aspiration in Uthaithani hospital. Sawanpracharak Medical J. 2004;1(3): 182-8.
51. Tangsathitporn R. Clinical and pathological characteristics of solitary thyroid nodules in Trang hospital. Songkla Med J. 2011;29(2): 65-75.
52. Vajrabukka T, Sapasiraporn W. Management of solitary thyroid nodule. Chula Med J. 2004;48(3): 191-212.
53. Flanagan MB, Ohori NP, Carty SE, Hunt JL. Repeat thyroid nodule fine needle aspiration in patient with initial benign cytologic result. Am J Clin Pathol. 2006;125(5): 698-702.
54. Gharib H, Mazzaferri EL. Thyroxine suppressive therapy in patient with nodular thyroid disease. Ann Intern Med. 1998;128(5):386-94.
55. Busseniers AE, Oertel YC. “Cellular adenomatoid nodules” of the thyroid: Review of 219 fine needle aspiration. Diagn Cytopathol. 1993;9(5):581-9.
56. Tsang K, Duggan MA. Vascular proliferation of the thyroid. A complication of fine-needle aspiration. Arch Pathol Lab Med. 1992;116(10):1040-1042.
57. Roh JL. Intrathyroid hemorrhage and acute upper airway obstruction after fine needle aspiration of the thyroid gland. Laryngoscope. 2006;116(1):154-156.
58. Noordzij JP, Goto MM. Airway compromise caused by hematoma after thyroid fine-needle aspiration. Am J Otolaryngol. 2005;26(6):398-399.