Malignancy rates in thyroid nodules classified as benign according to the nodule size threshold of 4 cm

Year 2024, Volume: 8 Issue: 1, 26 - 34, 30.04.2024

Yunushan Furkan Aydoğdu Emre Gülçek Çağrı Büyükkasap Kürşat Dikmen

https://doi.org/10.33716/bmedj.1424770

Abstract

SUMMARY
Aim: The false negative rate of fine needle aspiration biopsy (FNAB) in large thyroid nodules ranges from 7.7% to 53%. The treatment of nodules that are 4 cm or larger is controversial because of the potential for false-negative FNAB results. In order to make treatment recommendations for nodules ≥4 cm in size, we compared the results of preoperative FNAB with thyroid surgery specimens.
Materials and Methods: We evaluated patients who underwent thyroid surgery and had preoperative FNAB between 2017 and 2022. Patients were divided into two groups based on nodule size (<4 cm and ≥4 cm). FNAB and specimen pathology results of both groups were compared.
Results: 982 patients who underwent surgery for nodular disease were evaluated. Patients in the Bethesda 2 group (n=231) were divided into two categories based on nodule size: ≥4 cm (n=56) and <4 cm (n=175). Malignancy rates were higher in the group with tumors smaller than 4 cm. FNAB and specimen results were compared. A statistically significant difference was found between the groups (p = 0.039).
Conclusion: The benign fine-needle aspiration biopsy results were consistent with the specimen results in patients with nodules that were 4 cm or larger. Thyroid surgery should not be considered as the initial treatment for nodules ≥4 cm with benign cytology.

Keywords

Thyroid cancer, Nodular thyroid disease, Fine needle aspiration biopsy, Thyroidectomy, False negative rate

Nodül boyutu 4 cm üzerinde benign olarak sınıflandırılan tiroid nodüllerinde malignite oranları

Abstract

ÖZET
Amaç: Büyük tiroid nodüllerinde ince iğne aspirasyon biyopsisinin (İİAB) yanlış negatiflik oranı %7,7 ile %53 arasında değişmektedir. Yanlış negatif İİAB sonuçları potansiyeli nedeniyle 4 cm veya daha büyük nodüllerin tedavisi tartışmalıdır. Büyüklüğü 4 cm ve üzerindeki nodüllere tedavi önerilerinde bulunmak amacıyla preoperatif İİAB sonuçlarını tiroid cerrahisi spesmenleri ile karşılaştırdık.
Gereç ve Yöntem: 2017-2022 yılları arasında tiroid ameliyatı geçiren ve ameliyat öncesi İİAB yapılan hastaları değerlendirdik. Hastalar nodül boyutlarına göre (<4 cm ve ≥4 cm) iki gruba ayrıldı. Her iki grubun İİAB ve spesmen patoloji sonuçları karşılaştırıldı.
Bulgular: Nodüler hastalık nedeniyle ameliyat edilen 982 hasta değerlendirildi. Bethesda 2 grubundaki hastalar (n=231) nodül boyutlarına göre ≥4 cm (n=56) ve <4 cm (n=175) olmak üzere iki kategoriye ayrıldı. Tümörü 4 cm'den küçük olan grupta malignite oranları daha yüksekti. İİAB ve spesmen sonuçları karşılaştırıldı. Gruplar arasında istatistiksel olarak anlamlı fark bulundu (p=0,039).
Sonuç: Nodülü 4 cm ve üzerinde olan hastalarda benign ince iğne aspirasyon biyopsisi sonuçları spesmen sonuçlarıyla uyumluydu. Benign sitolojiye sahip ≥4 cm nodüllerde tiroid cerrahisi ilk tedavi seçeneği olarak düşünülmemelidir.

Keywords

Tiroid kanseri, Nodüler tiroid hastalığı, İnce iğne aspirasyon biyopsisi, Tiroidektomi, Yanlış negatiflik oranı

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