Levent SAYDAM, Mahmut Tayyar KALCIOĞLU, Ahmet KIZILAY, Mete Kaan BOZKURT

Tiroit nodüllerinin değerlendirilmesi: İnce iğne aspirasyon biyopsisinden sonra frozen section incelemesi gerekli mi?

Amaç : Ameliyat öncesi ince iğne aspirasyon biyopsisi İİAB sonuçlarını tek parametre olarak kullanarak tiroidektominin geniflliğine karar verilip verilemeyeceği vefrozen section incelemesinin her olguda rutin olarakgerekip gerekmediği arafltırıldı.Hastalar ve Yöntemler: Çalıflmaya nodüler tiroit tanısıyla tiroidektomi ameliyatı yapılan ve ameliyat öncesinde ince iğne aspirasyonu n=46 ve/veya ameliyat sırasında frozen section n=40 sonuçlarına ulaflılabilen 67 hasta alındı. İki yöntemin sonuçlarıyla patolojik inceleme sonuçları karflılafltırıldı.Bulgular: Histopatolojik sonuçlar 25 olguda %37.3 malign, 42 olguda %62.7 benign bulundu. İnce iğne aspirasyon biyopsisinin duyarlılığı %50, özgüllüğü %95, tanısal doğruluk oranı %77; frozen sectionincelemesinin duyarlılığı %100, özgüllüğü %87, tanısal doğruluğu %91 bulundu.Sonuç: Bulgularımız, İİAB’nin düflük duyarlılık ve tanısal doğruluk değerleri nedeniyle, klinik malignensi parametrelerinin dikkatle değerlendirilmesi ile birlikte rutinfrozen section incelemesinin gerekli olduğunu gösterm e k t e d i r

Anahtar Kelimeler:

Biyopsi, iğne, frozen section, duyarlılıkve özgüllük, tiroit hastalıkları/tanı, tiroit bezi/patoloji/cerrahi, tiroit neoplazmları/tanı, tiroit nodülü/patoloji/tedavi, tiroidektomi

The evaluation of thyroid nodules: is routine use of frozen-section examination necessary following preoperative fine-needle aspiration biopsy?

Objectives: We evaluated the role of fine-needle aspiration biopsy as a single parameter in determining the extent of thyroidectomy and the necessity of routine use of frozen-section examination in patients with nodular thyroid disease.Patients and Methods: We reviewed 67 patients 40 females, 27 males; mean age 44 years; range 17 to 78 years who undervvent thyroidectomy for nodular thyroid disease. Preoperative fine-needle aspiration biopsy and intraoperative frozen-section examination were per- formed in 46 patients and 40 patients, respectively. The results were compared with histopathologic diagnoses.Results: Histopathologically, 25 patients 37.3% had malignant and 42 patients 62.7% had benign disease. The sensitivity, specificity, and diagnostic accuracy were 50%, 95%, and 77% for fine-needle aspiration biopsy, and 100%, 87%, and 91% for frozen-section examination, respectively.Conclusion: İn view of lower sensitivity and accuracy rates for fine-needle aspiration biopsy, the routine use of frozen-section examination seems to be necessary especially in cases with highly suggestive clinical findings of malignancy.

Keywords:

Biopsy, needle, frozen sections, sensitivity and specificity, thyroid diseases/diagnosis, thyroid gland/pathology/surgery, thyroid neoplasms/diagnosis, thyroid nodule/ pathology/therapy, thyroidectomy,

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