[The thyroid nodule: cytomorphofunctional profile-therapeutic approach]

Area of Science:

• Endocrinology
• Oncology
• Diagnostic Cytopathology

Background:

• Thyroid nodules are common, requiring accurate diagnostic methods to differentiate benign from malignant lesions.
• Preoperative assessment is crucial for surgical planning and patient management.

Purpose of the Study:

• To assess the diagnostic value of preoperative echo-guided fine needle aspiration cytology (FNA) for thyroid nodules.
• To evaluate the role of ultrasonography in guiding FNA and monitoring therapeutic procedures.
• To determine the cost-effectiveness and impact of FNA on surgical intervention rates.

Main Methods:

• Analysis of a cohort of 16,400 thyroid nodules examined since 1982.
• Utilized ultrasonography for guiding fine needle aspiration cytology (FNA).
• Integrated clinical criteria, physical examination, laboratory tests, cytomorphology, and biomolecular studies.
• Preliminary investigation using Laser Capture Microdissection for molecular pattern analysis.

Main Results:

• Echo-guided FNA demonstrated absolute diagnostic reliability in discriminating benign from malignant thyroid nodules.
• Ultrasonography effectively guided FNA and monitored therapeutic interventions.
• Adoption of FNA significantly reduced unnecessary surgeries for benign lesions, increasing the detection rate of malignancy (approx. 3% prevalence).
• FNA proved to be a cost-effective tool, reducing healthcare costs by 20%.

Conclusions:

• Preoperative echo-guided FNA is a safe, non-invasive, and accurate diagnostic tool for thyroid nodules.
• This method optimizes surgical strategy, reduces healthcare costs, and improves the identification of malignant thyroid nodules.
• Emerging molecular analysis techniques like Laser Capture Microdissection show promise for early cancer detection and personalized treatment.