Thyroid nodules are common but thyroid malignancies are not. Fine needle aspiration (FNA) cytology is a diagnostic tool used to screen patients with thyroid nodules who require surgery. We study the diagnostic accuracy of FNA as the initial diagnostic modality in the clinical assessment of thyroid nodules. Between January 1995 until December 2000, 2131 FNA of thyroid nodules were performed. Four hundred and forty-one (20.7%) of these were unsatisfactory and 1690 (79.3%) cases were satisfactory for cytological evaluation. Histopathological diagnosis were available for 361 cases. Cyto-histopathological correlation was carried out for these cases. Our results showed a diagnostic accuracy of 96.2% with sensitivity and specificity rates of 87.7% and 98.4% respectively. Our positive predictive value is 93.4% and our negative predictive value is 96.8%. From this study, we conclude that fine needle aspiration is an important initial screening diagnostic tool for the investigation of thyroid nodules.
Fine Needle Aspiration (FNA) Cytology of the Thyroid: A Cyto-Histopathological Study of 361 Cases in Hospital Universiti Kebangsaan Malaysia
Author
Abstrak
Ketulan tiroid kerap ditemui tetapi neoplasma tiroid malignan jarang berlaku. Aspirasi sitologi jarum halus adalah kaedah diagnostik yang digunakan untuk menyaring pesakit tiroid yang memerlukan pembedahan. Kami mengkaji ketepatan diagnostik penggunaan aspirasi sitologi jarum halus sebagai kaedah modaliti diagnostik awal dalam penilaian klinikal ketulan tiroid. Sebanyak 2131 aspirasi jarum halus tiroid telah dilakukan di antara Januari 1995 dan Disember 2000 di Klinik FNA, Hospital Universiti Kebangsaan Malaysia (HUKM). Terdapat 441 (20.7%) kes-kes yang didapati tidak memuaskan untuk pemeriksaan sitologi manakala 1690 kes-kes yang selebihnya adalah memuaskan. Daripada jumlah ini, sebanyak 361 kes mempunyai diagnosis histopatologi. Korelasi sito-histopatologi dijalankan ke atas kes-kes ini. Keputusan kajian menunjukkan ketepatan diagnostik sebanyak 96.2% dengan kadar-kadar sensitiviti dan spesifisiti sebanyak 87.7% dan 98.4%. Nilai jangkaan positif adalah 93.4% dan nilai jangkaan negatif adalah 96.8%. Daripada keputusan kajian ini , kami merumuskan bahawa aspirasi jarum halus adalah kaedah diagnostik awal yang penting untuk penyiasatan ketulan tiroid.
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Related Images
 table1.jpg "Table 1. Results of FNA cytology")
 table2_0.jpg "Table 2. Results of FNA cytology with subsequent histopathological diagnosis.")
 table3.jpg "Table 3. Summary of cyto-histopathological cor-relation of all 361 cases")
 table4.jpg "Table 4. Calculations of diagnostic accuracy, sensitivity, specificity, negative and positive predictive values")
 image1.jpg "Figure 1: Papillary carcinoma. Pale and powdery nuclear chromatin with longitudinal grooves. (Papanicolaou stain, 400X)")
 image2.jpg "Figure 2: Follicular neoplasm displaying coarse chromatin pattern. (Papanicolaou stain, 400 X)")
