TİROİD İNCE İĞNE ASPİRASYONLARINDA İNCELENEN PREPARAT SAYISI İLE TANI ARASINDAKİ İLİŞKİ

Amaç Tiroid nodüllerinin tanısında kullanılan tek yöntem olan ince iğne aspirasyonunu değerlendirmede en yaygın kullanılan sistem Bethesda sistemidir. Semptomatik ve asemptomatik nodüllere uygulanan ince iğne aspirasyonunun yeterliliği hastanın uygun takip ve tedavisi için önemlidir. Çalışmanın amacı tiroid nodüllerinden yapılan aspirasyonlarda hazırlanan preparat sayısı ve aynı anda örneklenen nodül sayısı ile tanısal yeterlilik arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem 3747 olguya ait 5092 ince iğne aspirasyonu çalışmaya alındı. Olguların yaş ve cinsiyeti, nodül çapı, nodül başına örneklenen preparat sayısı, aynı seansta örneklenen nodül sayısı ve tüm nodüllerin tanıları not edildi. Preparat sayısı ve örneklenen nodül sayısı parametreleri kategorize edilerek tanı ile arasındaki ilişkiye bakıldı. Tüm veriler SPSS 20 programı kullanılarak analiz edildi. Bulgular İnce iğne aspirasyonlarının 3929’u (%77,2) kadın, 1163’ü (%22,8) erkek hastalardan yapılmıştı ve yaş ortalaması 52,3 (11-93 yaş) idi. Tek preparat ile incelenmiş aspirasyonlarda tanısallık oranı multipl preparat ile incelenenlere göre daha düşük idi (p=0,001). Multipl preparat ile incelenenlerde kuşkulu grup ve malign tanıları daha fazlaydı, tek preparat incelenenlerde ise benign tanı oranı daha yüksek idi (p=0,013). Tanı kategorilerine bakıldığında ise multipl nodülden yapılan aspirasyonlarda benign tanılar daha fazlayken, tek nodül aspirasyonlarında kuşkulu ve malign tanı daha fazla idi. Sonuç Aspirasyon yapılan nodülün ultrasonografik özellikleri ve yapılan işlemin doğruluğu tanıyı doğrudan etkilemektedir. Nodülden yapılan aspirasyonlarda nodülün birkaç alanından aspirasyon yapılması ve aspirasyonların tek preparata kıyasla iki ya da daha fazla preparat ile hazırlanmasının hem tanısallığı artırmak hem de kuşkulu ve malign tanı olasılığını artırmak için önemli olduğu sonucuna varıldı.

Anahtar Kelimeler:

tiroid, ince iğne, Bethesda, aspirasyon

THE RELATIONSHIP BETWEEN THE NUMBER OF SLIDES AND THE DIAGNOSIS IN THYROID FINE NEEDLE ASPIRATIONS

Objective The first method used in the diagnosis of thyroid nodules is the Bethesda system, which is the most widely used system to evaluate aspiration. The adequacy of aspiration applied to symptomatic and asymptomatic nodules is important for appropriate follow-up and treatment of the patient. The aim of the study is to evaluate the relationship between the number of slides prepared from thyroid nodules and nodules sampled at the same time, and diagnostic efficiency. Material and Method 5092 aspirations from 3747 cases were included in the study. The age and gender of the cases, the diameter of the nodules, the number of preparations, the number of nodules and the diagnosis of all nodules were noted. The number of preparations and the number of sampled nodules were categorized and their relationship with the diagnosis was examined. All data were analyzed using SPSS 20. Results Of the aspirations, 3929 (77.2%) were female and 1163 (22.8%) were male patients, and the mean age was 52.3 (11-93 years). The diagnostic rate of aspirations examined with a single preparation was lower than multiple preparations (p=0.001). Suspicious group and malignant diagnoses were higher in those who were examined with multiple preparations, and the rate of benign diagnosis was higher in those who were examined with a single preparation (p=0.013). Considering the diagnostic categories, while benign diagnoses were more common in aspirations from multiple nodules, suspicious and malignant diagnoses were more common in single nodule aspirations. Conclusion Ultrasonographic features of the nodule and the accuracy of the procedure directly affect the diagnosis. It has been concluded that aspiration from several areas of the nodule and the preparation of aspirations with two or more preparations compared to a single preparation are important both to increase the diagnosis and to increase the probability of suspicious and malignant diagnosis.

Keywords:

thyroid, fine needle, Bethesda, aspiration,

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