Evaluation of thyroid fine needle aspiration biopsy results between june 2017-June 2018 in Van YYÜ endocrinology clinic

Objective: Thyroid cancer is the most common endocrine gland malignancy and thyroid fine needle aspiration biopsy (FNAB) is widely used for the evaluation of thyroid nodules (1). In this study, we aimed to investigate the demographic and ultrasonographic characteristics of patients with thyroid nodules, the effect of recurrent FNAB on results, the comparison of postoperative pathology results with FNAB and the malignancy rate in our center retrospectively. Materials and Methods: Between June 2017 and June 2018, the hospital records of 631 patients aged between 18-80 years who underwent FNAB for thyroid nodules in the Endocrinology Policlinic of Van Yüzüncü Yıl University Medical Faculty were retrospectively reviewed. We analyzed parameters, including age, gender, the value of serum TSH, nodule size and localization, FNAB pathology results, presence of recurrent FNAB and recurrent FNAB pathology results, surgical pathologic diagnosis of patients underwent surgery and whether their nodules are solitary or multinodular. Results: The study comprised of 631 patients with mean age 45,5±12,8 years. 559 (%88,6) of the patients were females and 72 (%11,4) were males. The mean nodule size was 2.09 ± 1 cm and the mean TSH value was 1.34 ± 1.46 mU / mL. There was a positive correlation between age and nodule size (p = 0.040, r: 0.08). There was a statistically significant relationship between TSH level and benign, malignant and atypical FNAB pathology results (p = 0.012). The mean TSH value was 1.19 ± 1.09 mU / mL, 1.4 ± 0.83 mU / mL and 1.727 ± 2,6196 mU / mL in patients with benign, malignant and atypical pathology, respectively. Accordingly, TSH was found to be higher in patients with malignant and atypical cytology. Of 84 patients who underwent total thyroidectomy, thyroid pathology was reported as malignant in 50 (59.5%) and benign in 34 (40.5%). Of V 50 patients diagnosed as malignant pathology, 39 (78%) had multinodular goiter (MNG) and 11 (22%) had a single nodule. Multinodularity was found to be higher in patients with malignancy after surgery compared to solitary nodules (p = 0.031). Of the 50 patients with thyroidectomy who were reported to be malignant as a result of postoperative pathology, the last FNA result was malignant in 31(%62), atypical in 13, benign in 3, and inadequate in 3. According to the results of recurrent biopsies, the malignancy rate of our center was found to be 11% after exclusion of patients with inadequate pathology and 7.7% when all patients were included. In our study, TIAB sensitivity was 91.2%, specificity was 60%, positive predictive value (PPD) was 83.8%, negative predictive value (NPD) was 75%, false negative rate was 8%, false positive rate was 40%. Conclusion: There was no statistically significant difference between gender, age, nodule location, nodule size and malign or benign pathology result. In our study Sensitivity, Positive Predictive Value (PPD), false negative rate were similar to the literature, but specificity and Negative Predictive Value (NPD) were slightly lower and false positive rate was higher than the literature.