Robert Masereka1, Paul K Okeny2, Jane O Fualal3, Dan Wamala4. 1. Department of Surgery, Makerere University College of Health Sciences (MakCHS), P.O Box 7062 Kampala - Uganda. 2. Department of Surgery, Gulu Regional Referral and Teaching Hospital, P.O Box 160 Gulu - Uganda. 3. Department of Surgery, Mulago National Referral Hospital. 4. Department of Pathology, Mulago NationalReferral Hospital.
Abstract
BACKGROUND: Thyroid disease affects about 5% of the World's population. Fine Needle Aspiration Cytology (FNAC) helps in planning extent of surgery. In some studies, FNAC has been found to have a low accuracy for malignancy. OBJECTIVES: To estimate the sensitivity and specificity of FNAC in detecting malignancy for thyroid disease using histopathology as the gold standard. METHODS: Patients who underwent clinical and laboratory evaluation and thyroidectomy at Mulago National Referral hospital and the Pathology department of Makerere University College of Health Sciences were consecutively recruited over a four months period. Analysis using STATA version 10 focused on sensitivity, specificity and accuracy of FNAC in detecting malignancy. RESULTS: In total, 99 patients were recruited, the F:M ratio was 15.5:1 and median age was 42 years (IQR 34-50). The median duration of symptoms was 364 weeks (IQR 104-986). The proportion of patients with malignancy was 13.3% with papillary thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity was 61.5% and specificity 89.5%. CONCLUSION: This study revealed high specificity and low sensitivity of Fine Needle Aspiration Cytology (FNAC) at detecting malignancy in thyroid nodules.
BACKGROUND:Thyroid disease affects about 5% of the World's population. Fine Needle Aspiration Cytology (FNAC) helps in planning extent of surgery. In some studies, FNAC has been found to have a low accuracy for malignancy. OBJECTIVES: To estimate the sensitivity and specificity of FNAC in detecting malignancy for thyroid disease using histopathology as the gold standard. METHODS:Patients who underwent clinical and laboratory evaluation and thyroidectomy at Mulago National Referral hospital and the Pathology department of Makerere University College of Health Sciences were consecutively recruited over a four months period. Analysis using STATA version 10 focused on sensitivity, specificity and accuracy of FNAC in detecting malignancy. RESULTS: In total, 99 patients were recruited, the F:M ratio was 15.5:1 and median age was 42 years (IQR 34-50). The median duration of symptoms was 364 weeks (IQR 104-986). The proportion of patients with malignancy was 13.3% with papillary thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity was 61.5% and specificity 89.5%. CONCLUSION: This study revealed high specificity and low sensitivity of Fine Needle Aspiration Cytology (FNAC) at detecting malignancy in thyroid nodules.
Entities:
Keywords:
Diagnostic accuracy; cytology; fine needle aspiration; tertiary hospital; thyroidectomy
Authors: Chung-Che Charles Wang; Lyssa Friedman; Giulia C Kennedy; Hui Wang; Electron Kebebew; David L Steward; Martha A Zeiger; William H Westra; Yongchun Wang; Elham Khanafshar; Giovanni Fellegara; Juan Rosai; Virginia Livolsi; Richard B Lanman Journal: Thyroid Date: 2010-12-29 Impact factor: 6.568