INTRODUCTION: The aim of present study is to compare the preoperative sonographic findings, fine-needle aspiration biopsy (FNAB) and postoperative histopathological results in patients who underwent total thyroidectomy.
METHODS: A total of 884 patients (685 females 199 males; average age 46.84± 12.73; range 16 82 years) who underwent total thyroidectomy were included in this study. Thyroid ultrasonography was performed in all of patients with an initial diagnosis of thyroid nodules. Sonographic findings of thyroid nodules were evaluated. The sonographic characteristics were the number of nodules and sizes, having microcalciﬁcations, having irregular margins and echogenicity. Sonographic malignancy scores were calculated due to sonographic findings. All thyroidectomy specimens were sent for pathological evaluation. The specimens were divided into two groups, benign and malign group, due to pathological evaluation. Each groups were compared in terms of preoperative sonographic findings, FNAB and postoperative histopathological results.
RESULTS: The sonographic malignancy scores were statistically higher in malignancy group than in benign group (p=0.000). Nodule size was smaller in malignancy group than in benign group (p=0.000). Capsule irregularity rate was statistically higher in malignancy group than in benign group (p=0.000). Hypoechogenicity rate was statistically higher in malignancy group than in benign group (p=0.000). There was statistically significant consistency between pathology and FNAB results (kappa= 0.478, p=0.000). The sensivity, specificity, positive predictive and negatif predictive values of FNAB were %55.7, %92.4, %72.5 and %82.9, respectively.
DISCUSSION AND CONCLUSION: Although the thyroid FNAB has an acceptable sensitivity and specificity, it is not effective alone in the decision of operation. Risk factors of thyroid malignancy should also be considered when assessing FNAB results, which are accepted as the gold standard in approach to thyroid nodules.