[Needle aspiration cytology in thyroid surgery (our experience in 104 operated cases)]

In the least years Fine Needle Aspiration Biopsy (FNAB) is more and more becoming a routine exam in the thyroid diagnostics. Nevertheless, its exact role and diagnostic value is still an argument under discussion, in spite of well known usefulness and safety of the method. The aim of this study, based on our experience, is to verify, if and how much FNAB findings could have modified the diagnostic schedule, the surgical indications and the number of malignancies in a group of operated patients for thyroid nodular disease. In this experience a series of 104 patients have been studied in the Ia Clinica Chirurgica-Ia Facoltà, Università degli Studi di Napoli in the years 1988-90; the indication for a surgical treatment was due to a nodular thyroid disease. Aspiration cytology was performed in these patients before surgery and afterwards was determined the correlation between cytologic and hystological findings. The clinical and scan assessment also contributed to indicate the surgical management of the disease. On the basis of this study FNAB has to be considered as a quite reliable diagnostic tool in thyroid lesions; it results free of complications, with good sensitivity (75%), specificity (82.6%) and diagnostic accuracy (81.7%). A peculiar consequence of the use of cytology, is the increased number of adenoca (11.5%) preoperatively diagnosed, a percentage of which otherwise would have been a histopathological postoperative "surprise". However, the possibility of "false negative" and "false positive" lends further support to the concept that FNAB alone cannot determinate the choice between medical or surgical treatment of thyroid nodular lesions.