Correlation between cytological and histopathological study in the diagnosis of differentiated thyroid carcinoma
Keywords:
thyroid carcinoma, fine needle aspiration, citology, histopathologyAbstract
Differentiated thyroid carcinoma (CDT) comprises 1% of all carcinomas and is the most common endocrine malignant neoplasia. The gold standard in thyroid nodule diagnosis, in addition to ultrasound, is histopathological study, but fine needle aspiration (FNA) is simple, safe and has high rates of specificity and sensitivity. It is important to establish the degree of concordance between the two methods to make appropriate therapeutic decisions.
Objective: To determine the correlation between the cytological and histopathological study in CDT Diagnostics.
Methodology: The study is descriptive, correlational, non-experimental and cross-sectional; included 237 patients with suspected thyroid cancer (CT) external endocrinology consultation of the hospital “Teodoro Maldonado Carbo” in Guayaquil period January 2016 to December 2017.
Results: The diagnosis with FNA, according to the Bethesda (SB) System found 144 patients with CDT, corresponding to category IV 14.8%, V 13.5% and VI 32.5% of the total. Papillary carcinoma represented 96% of total and follicular carcinoma only 4%. The histopathological examination reported 204 patients (86.1%) with CDT. The evaluation of the diagnostic methods showed a sensitivity of 67.2%, specificity 78.8%, reliability 69%. VPP 95%, VPN 27%. Conclusion: Cytologic study with SB is the acceptable method of predicting that a patient has CT, but is questionable to predict that he does not have it. The cytologic study, through FNA, if it has diagnostic concordance with histopathological study in the CDT.
References
Arul, P., & Masilamani, S. (2015). A correlative study of solitary thyroid nodules using the bethesda system for reporting thyroid cytopathology.- Tamil Nadu-India. Journal of Cancer Research and Therapeutics. Vol 11, 617- 622.
Arul, P; Akshatha, C. (2015). A study of malignancy rates in different diagnostic categories of the Bethesda system for reporting thyroid cytopathology: An institutional experience.- Tamil Nadu-India. Biomedical Journal. Vol 38, 517-522.
Benítez, I., Vielma, M., & Zerpa, Y. (2017). Caracteristicas clínicas, manejo y evolución del carcinoma de tiroides en el instituto autónomo hospital universitario de los andes, mérida, venezuela: importancia de la clasificación de riesgo. Revista Venezolana de Endocrinología y Metabolismo Vol 15, 48-59.
Bibbins, D., Grossman, D., & et.al. (2017). Screening for Thyroid Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Vol 317, 1882 - 1887.
Blum, M. (5 de agosto de 2018). Overview of the clinical utility of ultrasonography in thyroid disease. Obtenido de Overview of the clinical utility of ultrasonography in thyroid disease: https://www.uptodate.com/contents/overview-of-the-clinical-utility-of-ultrasonography-in-thyroid-disease
Blum, M. (6 de agosto de 2018). Ultrasound- guided thyroid biopsy. Obtenido de Ultrasound- guided thyroid biopsy: https://www.uptodate.com/contents/ultrasound-guided-thyroid-biopsy
Blum, M. (5 de agosto de 2018). Technical aspects of thyroid ultrasound. Obtenido de Technical aspects of thyroid ultrasound: https://www.uptodate.com/contents/technical-aspects-of-thyroid-ultrasound
Cavallo, A., & Johnson, D. (6 de agosto de 2018). Medline ® Abstract for Reference 22 of «Overview of the clinical utility of ultrasonography in thyroid disease». Obtenido de Medline ® Abstract for Reference 22 of «Overview of the clinical utility of ultrasonography in thyroid disease»: https://www.uptodate.com/contents/overview-of-the-clinicac-utilty-of-ultrasonography-in-thyroid-disease
Cerdas, A. (2014). Histopatología del cáncer de tiroides. Revista Médica de Costa Rica y Centro América. Vol 610, Página 253-258.
Cibas, E; Ali, S. (2014). The Bethesda System for Reporting Thyroid Cytopathology. American Journal of Clinical Pathology. Vol 132., 658-665.
Cibas, E; Ali, S. (2017). The 2017 Bethesda System for Reporting Thyroid Cytopathology.- Boston, Massachusetts-USA. Thyroid: Official Journal of the American Thyroid Association. Vol 27, 1341-1346.
Dorantes, A., Tripp, A., & Martínez, S. (2016). Endocrinología clínica de Dorantes y Martínez.- México-D.F. . En A. Dorantes, A. Tripp, & S. Martínez, Endocrinología clínica de Dorantes y Martínez (págs. 144-152). México: El Manual Moderno.
Fernández, V., Llorente, J., & et.al. (2018). Manejo de los carcinomas diferenciados de tiroides.- Barcelona-España. Acta Otorrinolaringológica Española. Publicado por Elsevier España, 1-7.
Gómez, J. (2014). Cáncer de Tiroides. Barcelona-España: Elsevier.
Grob, F., Carrillo, D., & et.al. (2014). Concordancia de la citología por punción con aguja fina para la detección de cáncer de tiroides en pediatría.- Santiago de Chile-Chile. Revista médica de Chile. Vol 142, 330-335.
Haugen, B., Alexander, & et.al. (2016). American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.- Aurora-Colorado-US. Thyroid: Official Journal of the American Thyroid Association. Vol 26, 1-133.
Jácome, A. (2015). Vista de Cáncer diferenciado de Tiroides. ¿Por qué está aumentando su frecuencia? Revista Medicina. Vol 37, 185-196.
Kwong, N., Medici, M., & Angell, T. (2015). The Influence of Patient Age on Thyroid Nodule Formation, Multinodularity, and Thyroid Cancer Risk. The Journal of Clinical Endocrinology and Metabolism. Vol 100, 4434 - 4440.
Lai, X., & Liu, M. (2016). Hypervascularity is more frequent in medullary thyroid carcinoma: Compared with papillary thyroid carcinoma.- Beijing-China. . Medicine. Vol 95, 1-5.
Malchoff, C. (8 de julio de 2018). Oncogenes and tumor suppressor genes in thyroid nodules and nonmedullary thyroid cancer. Obtenido de Oncogenes and tumor suppressor genes in thyroid nodules and nonmedullary thyroid cancer:
Mitchell, A., Gandhi, A., Scott-Coombes, D., & Perros, P. (2016). Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines.- Cambridge-Reino Unido. The Journal of Laryngology and Otology. Vol 130. , 150-160.
Mora, G., Muñoz, J., & et.al. (2018). Rendimiento del sistema Bethesda en el diagnóstico citopatológico del nódulo tiroideo.- Barcelona-España. . Cirugía Española. Vol 96, 363-368.
Muratli, A., Erdogan, N., & et.al. (2014). Diagnostic efficacy and importance of fine- needle aspiration cytology of thyroid nodules.- Istanbul-Turkey. Journal of Cytology / Indian Academy of Cytologists. Vol 31, 73-78.
National Cancer Institute. (5 de julio de 2018). Thyroid Cancer - Cancer Stat Facts. Obtenido de Thyroid Cancer - Cancer Stat Facts: https://seer.cancer.gov/statfacts/html/thyro.html
Nikiforov, Y., Seethala, R, & et.al. (2016). Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma: A Paradigm Shift to Reduce Overtreatment of Indolent Tumors.- Pittsburgh- US. . JAMA Oncology. Vol 2, 1023-1029.
Osorio, C., Grice, J., & et.al. (2015). Riesgo de malignidad en citología obtenida mediante aspiración con aguja fina de la glándula tiroides.- Cartagena-Colombia. Revista Ciencias Biomédicas. Vol 6, 22-28.
Pinto, J., Valle, A., & et.al. (2014). Sistema Bethesda en el diagnóstico citopatológico de la patología de tiroides.- Cantabria-España. Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja. Vol 5, 66-74.
Rodriguez, H. (2017). Evaluación de la precisión diagnóstica de la punción aspiración con aguja fina en pacientes con nódulo tiroideo.- Manizales-Colombia. Biosalud. Vol 16, 11-18.
Romero, R. (2014). Implementación del Sistema Bethesda para el informe de citología aspirativa de tiroides con seguimiento histopatológico: experiencia en un centro de tratamiento de cáncer.- Bogotá-Colombia. Revista Colombiana de Cancerología. Vol 18, 3- 7.
Rong, R., Wu, Y., & et.al. (2016). Fine needle aspiration cytology of thyroid nodules: a cytopathologic study of 2043 cases.- China. Zhonghua Bing Li Xue Za Zhi. Chinese Journal of Pathology. Vol 45, 368-371.
Ross, D. (8 de julio de 2018). Diagnostic approach to and treatment of thyroid nodules. Obtenido de Diagnostic approach to and treatment of thyroid nodules: UpToDate
Sandrone, S., Burgesser, M., & et.al. (2014). Punción-aspiración con aguja fina tiroidea y su correlación diagnóstica con las piezas quirúrgicas. Siete años de experiencia en Córdoba, Argentina.- Córdova-Argentina. Revista Española de Patología. Vol 41, 195-202.
