Nodüler guatr nedeniyle opere edilen olguların ultrasonografi ve tiroid ince iğne aspirasyon biyopsi özellikleri

Amaç: Tiroid nodüllerinin değerlendirilmesinde klinik özelliklerin yanısıra tiroid ince iğne aspirasyon biyopsisi (İİAB) ve ultrasonografi maligniteyi predikte etmede kullanılan yöntemlerdir. Özellikle folliküler neoplazi ve önemi belirsiz atipi gibi indetermine lezyonlarda cerrahi kararı verebilmek için tiroid İİABnin yanlış negatif ve yanlış pozitiflik insidanslarının bilinmesi önemlidir. Bu çalışmadaki amacımız histolojik olarak malign olduğu saptanan tiroid nodüllerinin ultrasonografik özelliklerini incelemek ve yapılan tiroid İİABnde saptanan indetermine sitolojilerin histopatoloji korelasyonlarını değerlendirmektir. Yöntemler: Ocak 2010-Ocak 2012 tarihleri arasında nodüler guatr nedeni ile tiroidektomi yapılan 154 hastanın demografik özellikleri, sitoloji ve histopatoloji sonuçları, nodüllerin ultrasonografik özellikleri, operasyon öncesi TSH değerleri retrospektif olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen hastaların 104 (%67,5)ünün histopatoloji sonucunun benign, 50sinin ise (%32,5) malign olduğu görüldü. İki grup arasında yaş ve cinsiyet açısından fark saptanmadı. Histopatoloji sonucu benign olan gruptaki hastaların TSH düzeylerinin malign gruba göre anlamlı düşük olduğu görüldü. Bu çalışmada kliniğimizde yapılan tiroid İİABnin sensitivitesi %90.7, spesifitesi %72.2 , pozitif prediktif değeri %62.7, negatif prediktif değeri ise %93.8 olarak hesaplandı. Tiroid İİABnin tanısal doğruluk değeri %78.5 olarak bulundu. Çalışmamızda Önemi Belirsiz Atipi sıklığı %7 olarak hesaplandı ve bu lezyonların %25inin histopatolojik olarak malign oldukları bulundu. Ultrasonografik özellikler değerlendirildiğinde; malign histopatolojinin bağımsız risk faktörleri hipoekojenite (OR=2.3 p

Ultrasonographic and fine needle aspiration biopsy characteristics of patients operated for nodular goitre

Objective: Fine needle aspiration (FNA) biopsy and ultrasonography are the methods used to evaluate thyroid nodules and to predict malignancy together with the clinical characteristics of nodules. It is important to know false positive and false negative incidences of FNA especially in the case of follicular neoplasia or indeterminate lesions such as atypia of undetermined significance (AUS) to decide whether surgery is necessary or not. The aim of this retrospective study was to evaluate ultrasonographic characteristics of histopathologically verified malignant thyroid nodules and histopathologic correlation of cytologically indeterminate lesions with histopathologic diagnosis. Methods: One hundred and fifty-four patients who underwent thyroidectomy between January 2010 and January 2012 are included in this study. Demographic characteristics, cytological and histopathological results, preoperative TSH levels of all patients and ultrasonographic characteristics of the nodules were evaluated retrospectively. Results: Histopathology of 104 patients (67.5%) was benign and 50 patients (32.5%) was malignant. TSH levels in the group of benign pathology are significantly lower than the group of malignant ones. Sensitivity, specifity, positive predictive value and negative predictive value of FNA were calculated as 90.7%, 72.2%, 62.7%, 93.8%, respectively. Diagnostic accuracy of FNA was 78.5%. Incidence AUS was calculated as 7% and 25% of these lesions were histopathologically malignant. Hypoechogenicity (OR=2.3, p

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