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2004, Number 3

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Cir Gen 2004; 26 (3)

Fine needle aspiration biopsy or transoperative frozen section study in the management of the thyroid nodule

Hurtado-López LM, Ramírez-Velásquez JE, Muñoz SÓ

Language: Spanish
References: 18
Page: 159-162
PDF size: 53.94 Kb.


ABSTRACT

Objective: To determine whether fine-needle aspiration biopsy (FNAB) and the transoperative frozensection study (TOFS) of the thyroid nodule (TN) complement each other or one eliminates the other, and which is better.
Material and methods: A prospective, longitudinal, analytical, blind study with diagnostic reference standard was performed in 182 patients. The studied variables were: capacity to detect cancer through FNAB and TOFS as compared to the final histopathological result. We analyzed statistically: sensitivity, specificity, diagnostic accuracy, positive and negative predictive values (PV), prevalence, and positive and negative odds ratio.
Results: We studied 167 women and 15 men, average age of 43.5 years (range 16-86). The definitive histopathological study revealed that the TN was malignant in 69 patients (38%) and benign in 113 (62%). FNAB diagnosed malignancy in 40 cases (22%), benign disease in 80 (44%), undetermined in 53(29%), and was inadequate in 9 (5%). The diagnosed cases presented 81.2% sensitivity, 98.6% specificity, 97.5% +VP, and 88.7% -VP, 91.6% accuracy. The TOFS was positive for cancer in 46 (25.3%), negative in 99 (54.3%), follicular tumor in 37 (20.4%), with a sensitivity of 81.8%, specificity of 100%, +PV of 100%, -VP of 89.7%, accuracy of 92.3%. Six of nine false negatives from FNAB were identified through TOFS; 21 of the 62 non-diagnostic FNAB corresponded to cancer, TOFS only detected six of them. Thirteen of 37 non-diagnostic TOFS corresponded to cancer; FNAB only detected three of them.
Conclusion: Both studies have the same diagnostic capacity when the sample is diagnostic. When the sample is not diagnostic, the use of both does not improve the diagnostic capacity. TOFS is reliable to detect the false negatives from FNAB.


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