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FACTORS AFFECTING MALIGNANCY IN THYROID NODULES WITH NON-DIAGNOSTIC FINE NEEDLE ASPIRATION BIOPSY RESULT
U Karabacak1, M Derebey2, I A Tarim2
1Cumhuriyet University, Faculty of Medicine - Surgical Oncology, Sivas, Turkey.
Acta Endocrinologica (Bucharest, Romania : 2005)
|October 10, 2022
Summary
Non-diagnostic fine needle aspiration biopsy (FNAB) results for thyroid nodules can lead to unnecessary surgeries. This study found that 28% of initially non-diagnostic nodules were malignant, with ultrasonography features like solid structure and lymphadenopathy aiding diagnosis.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Non-diagnostic (ND) fine needle aspiration biopsy (FNAB) results pose challenges in thyroid nodule evaluation, potentially leading to unnecessary thyroidectomies.
- Accurate diagnosis is crucial for managing thyroid nodules and determining the need for surgery.
Purpose of the Study:
- To investigate the incidence of malignancy in thyroid nodules with initial ND FNAB results.
- To identify ultrasonography (USG) findings associated with malignancy in these nodules.
- To assess the effectiveness of repetitive biopsies.
Main Methods:
- Retrospective analysis of 156 consecutive thyroid nodules with initial ND FNAB results that underwent thyroidectomy.
- Evaluation of malignancy rates after initial and repeat FNABs.
- Correlation analysis of USG features with malignancy, including solid structure, microcalcification, cervical lymphadenopathy (LAP), and USG risk patterns.
Main Results:
- Malignancy was detected in 28% of nodules with an initial ND FNAB.
- Repeat FNAB yielded ND results in 31% of cases, with a 23% malignancy rate for nodules with two consecutive ND results.
- Solid nodule structure and cervical LAP were independent predictors of malignancy on multivariate analysis.
Conclusions:
- Diagnostic thyroidectomy is an effective method for diagnosing malignancy in selected patients with ND FNAB results, especially when considering USG findings.
- Ultrasonography features, particularly solid nodule structure and cervical lymphadenopathy, are valuable in predicting malignancy in non-diagnostic thyroid nodules.
