THE RELATIONSHIP BETWEEN THE NUMBER OF SLIDES AND THE DIAGNOSIS IN THYROID FINE NEEDLE ASPIRATIONS

Year 2022, Volume: 29 Issue: 3, 378 - 384, 30.09.2022

Ayça Tan , Aydın İşisağ

https://doi.org/10.17343/sdutfd.1101183

Abstract

Objective
The first method used in the diagnosis of thyroid
nodules is the Bethesda system, which is the most
widely used system to evaluate aspiration. The
adequacy of aspiration applied to symptomatic and
asymptomatic nodules is important for appropriate
follow-up and treatment of the patient. The aim of
the study is to evaluate the relationship between the
number of slides prepared from thyroid nodules and
nodules sampled at the same time, and diagnostic
efficiency.
Material and Method
5092 aspirations from 3747 cases were included
in the study. The age and gender of the cases, the
diameter of the nodules, the number of preparations,
the number of nodules and the diagnosis of all
nodules were noted. The number of preparations and
the number of sampled nodules were categorized and
their relationship with the diagnosis was examined. All
data were analyzed using SPSS 20.
Results
Of the aspirations, 3929 (77.2%) were female and
1163 (22.8%) were male patients, and the mean
age was 52.3 (11-93 years). The diagnostic rate of
aspirations examined with a single preparation was
lower than multiple preparations (p=0.001). Suspicious
group and malignant diagnoses were higher in those
who were examined with multiple preparations, and
the rate of benign diagnosis was higher in those who
were examined with a single preparation (p=0.013).
Considering the diagnostic categories, while benign
diagnoses were more common in aspirations from
multiple nodules, suspicious and malignant diagnoses
were more common in single nodule aspirations.
Conclusion
Ultrasonographic features of the nodule and the
accuracy of the procedure directly affect the diagnosis.
It has been concluded that aspiration from several
areas of the nodule and the preparation of aspirations
with two or more preparations compared to a single
preparation are important both to increase the
diagnosis and to increase the probability of suspicious
and malignant diagnosis.

Keywords

thyroid, fine needle, Bethesda, aspiration

TİROİD İNCE İĞNE ASPİRASYONLARINDA İNCELENEN PREPARAT SAYISI İLE TANI ARASINDAKİ İLİŞKİ

Abstract

Amaç
Tiroid nodüllerinin tanısında kullanılan tek yöntem
olan ince iğne aspirasyonunu değerlendirmede en
yaygın kullanılan sistem Bethesda sistemidir. Semptomatik
ve asemptomatik nodüllere uygulanan ince
iğne aspirasyonunun yeterliliği hastanın uygun takip
ve tedavisi için önemlidir. Çalışmanın amacı tiroid nodüllerinden
yapılan aspirasyonlarda hazırlanan preparat
sayısı ve aynı anda örneklenen nodül sayısı ile
tanısal yeterlilik arasındaki ilişkiyi değerlendirmektir.
Gereç ve Yöntem
3747 olguya ait 5092 ince iğne aspirasyonu çalışmaya
alındı. Olguların yaş ve cinsiyeti, nodül çapı, nodül
başına örneklenen preparat sayısı, aynı seansta örneklenen
nodül sayısı ve tüm nodüllerin tanıları not
edildi. Preparat sayısı ve örneklenen nodül sayısı
parametreleri kategorize edilerek tanı ile arasındaki
ilişkiye bakıldı. Tüm veriler SPSS 20 programı kullanılarak
analiz edildi.
Bulgular
İnce iğne aspirasyonlarının 3929’u (%77,2) kadın,
1163’ü (%22,8) erkek hastalardan yapılmıştı ve yaş
ortalaması 52,3 (11-93 yaş) idi. Tek preparat ile incelenmiş
aspirasyonlarda tanısallık oranı multipl preparat
ile incelenenlere göre daha düşük idi (p=0,001).
Multipl preparat ile incelenenlerde kuşkulu grup ve
malign tanıları daha fazlaydı, tek preparat incelenenlerde
ise benign tanı oranı daha yüksek idi (p=0,013).
Tanı kategorilerine bakıldığında ise multipl nodülden
yapılan aspirasyonlarda benign tanılar daha fazlayken,
tek nodül aspirasyonlarında kuşkulu ve malign
tanı daha fazla idi.
Sonuç
Aspirasyon yapılan nodülün ultrasonografik özellikleri
ve yapılan işlemin doğruluğu tanıyı doğrudan etkilemektedir.
Nodülden yapılan aspirasyonlarda nodülün
birkaç alanından aspirasyon yapılması ve aspirasyonların
tek preparata kıyasla iki ya da daha fazla
preparat ile hazırlanmasının hem tanısallığı artırmak
hem de kuşkulu ve malign tanı olasılığını artırmak için
önemli olduğu sonucuna varıldı.

Keywords

tiroid, ince iğne, Bethesda, aspirasyon

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