Hakan ŞARLAR, Enver İLHAN, Mehmet Akif ÜSTÜNER, Abdullah ŞENLİKCİ, Orhan ÜREYEN

NODÜLER GUATR TANISI İLE AMELİYAT EDİLEN VAKALARDA MALİGNİTE SIKLIĞI

Bu çalışmada tiroid nodülü nedeniyle ameliyat edilen hastalarda demografik, laboratuar, görüntüleme ve sitoloji bulgularının histopatoloji sonuçlarıyla ilişkisi araştırıldı. Nodüler guatr tanısıyla ameliyat edilen olgular yaş, cinsiyet, nodül sayısı, nodül boyutu, fonksiyon durumu, hormon profili, ameliyat tipi, sitoloji ve histopatoloji sonuçlarına göre retrospektif olarak değerlendirildi. Toplam 179 olgunun 147 %82.1 ’si kadın, 32 %17.9 ’si erkek idi. Ortalama yaş 51.3 aralık 22- 81 idi. Olguların çoğunluğu %69.3 30-60 yaş grubundaydı. Multinodüler guatr 142 %79.3 , soliter nodül 37 %20.7 olguda mevcuttu. Toplam 41 hastaya İİAB yapıldı. Bunlardan 19 %46.3 ’u yetersiz materyal olarak değerlendirildi. Geri kalan 22 %53.7 olgunun 15’i benign, beşi şüpheli malign ve ikisi malign tanısı aldı. Histopatolojik olarak malignite saptanan 27 %15.09 olgunun; 15 %55.6 ‘inde papiller karsinom, 3 %11.1 ’ünde papiller mikrokarsinom, 6 22.2 ’sında folliküler karsinom, 3 %11.1 ’ünde Hurthle hücreli karsinom tesbit edildi. Bunların 21 %77.8 ’i multinodüler, 6 %22.2 ’sı soliter nodülü olan hastalardı. Histopatoloji sonuçları ile yaş p =0.601 , cinsiyet p =0.790 ,nodül sayısı p=0.829 , nodül boyutu p=0.845 , tiroid fonksiyon durumu 0.744 , hormon profili p=0.206 , sitoloji p=0.227 ve ameliyat tipi p=0.350 arasında istatistiksel olarak anlamlı ilişki tesbit edilmedi. Tiroid nodülü tesbit edilen hastalarda ameliyat gereksinimini azaltmak ve tiroidektominin istenmeyen etkilerinden kaçınmak için cerrah, radyolog ve patolog işbirliği ile sitolojik tetkik uygulama ve değerlendirmede başarı ve beceriyi geliştirmek için gerekli çaba sarfedilmelidir.

Anahtar Kelimeler:

Tiroid nodülü, tiroid kanseri, ince iğne aspirasyon biopsisi

THE INCIDENCE OF MALIGNANCY IN CASES WHO OPERATED WITH DIAGNOSIS OF NODULAR GOITER

In this study, we examined the relationship between demographic, laboratory, imaging and cytology results with histopathology results in patients who underwent surgery for thyroid nodules. Patients who underwent surgery for nodular goiter were evaluated retrospectively according to age, gender, number of nodules, nodule size, functional status, hormones, surgery type, cytology and the results of histopathology. A total of 179 patients, 147 82.1% were female and 32 17.9% were male. Mean age was 51.3 range 22-81 years. The majority of patients 69.3% were between 30-60 years of age. There was multinodular goiter in 142 79.3% cases and solitary nodules in 37 20.7% cases. FNAB was performed in 41 patients. 19 46.3% of these patients were evaluated as non diagnostic material. The remaining 22 53.7% were diagnosed 15 cases were benign, five cases were suspected malignant and two caes were malignant. Histopathological examination of 27 patients with diagnosed malignancy, papillary carcinoma, papillary microcarcinoma, follicular carcinoma and Hurthle cell carcinoma were detected in 15 55.6% , 3 11.1% , 6 22.2 and 3 11.1% cases respectively. 21 77.8% of the patients had multinodular goitre and 6 22.2% patients had solitary nodules. There was not found to be statistically significant relationship between the results of histopathology with age p = 0.601 , gender p = 0.790 , number of nodules p = 0829 , nodule size p = 0845 , thyroid function status 0744 , hormonal profile p = 0.206 , cytology p = 0227 and type of surgery p = 0.350 . Surgeons, radiologists, and pathologists should be made to develop the skill in collaboration with cytological examination and evaluation of implementation success and efforts for reducing the need for surgery in patients with thyroid nodules identified and avoiding undesirable effects of thyroidectomy.

Keywords:

Thyroid nodule, thyroid carcinoma, fine needle aspiration biopsy,

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