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Volume 16, Issue 1 (2024)
Iran J War Public Health 2024, 16(1): 99-104 |
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Received: 2023/09/11 | Accepted: 2024/04/24 | Published: 2024/05/21
Received: 2023/09/11 | Accepted: 2024/04/24 | Published: 2024/05/21
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Baqir Q, Abbas S, Baqer F. Prediction of Malignancy in Thyroid Nodules; A Retrospective Comparative Study. Iran J War Public Health 2024; 16 (1) :99-104
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1- Department of Surgery, College of Medicine, University of Basrah, Basrah, Iraq
2- Department of Pharmacology, College of Medicine, University of Basrah, Basrah, Iraq
3- Department of Surgery, Al-Sader Teaching Hospital, Basrah, Iraq
2- Department of Pharmacology, College of Medicine, University of Basrah, Basrah, Iraq
3- Department of Surgery, Al-Sader Teaching Hospital, Basrah, Iraq
Abstract (695 Views)
Aim: This study assessed the potential of malignancy in patients presenting with clinically solitary thyroid nodules and compared the histopathology of excised samples and sonographic characteristics and fine-needle aspiration cytology results.
Participants & Methods: This retrospective study was conducted over three years on data from 140 patients attended general surgery outpatient departments at Al-Sader Teaching Hospital and a private clinic with different complaints of solitary thyroid nodules. The collected data included initial diagnoses according to the results of clinical assessment, ultrasound evaluation, fine-needle aspiration cytology, and histopathological examination.
Findings: As confirmed by histopathological examination, the prevalence of malignancy in clinical solitary thyroid nodules was 9.29% with male patients affected more than females (15% vs. 8.33%). Clinical assessment was a poor predictor for malignancy, as it was associated with a low sensitivity rate (69.23%), which means high false negative results, despite its high specificity rate (92.91%). According to the ultrasound examination, most malignancies were found in solid and mixed nodules (85% and 15%, respectively) with a significant association between the nature of nodules and malignancy potential. Fine-needle aspiration cytology was the most sensitive and specific investigation of thyroid nodules, it combined both high sensitivity and specificity for diagnosing malignant thyroid nodules (90.91% and 97.65%) respectively. Positive and negative predictive values were 79.83% and 99.06% respectively with an overall agreement of 97.02%.
Conclusion: Fine-needle aspiration cytology is a minimally invasive diagnostic tool for the early detection of malignancy among patients with solitary thyroid nodules, which combines high degrees of both specificity and sensitivity with a high accuracy rate of 97.02% comparable to histological examination.
Participants & Methods: This retrospective study was conducted over three years on data from 140 patients attended general surgery outpatient departments at Al-Sader Teaching Hospital and a private clinic with different complaints of solitary thyroid nodules. The collected data included initial diagnoses according to the results of clinical assessment, ultrasound evaluation, fine-needle aspiration cytology, and histopathological examination.
Findings: As confirmed by histopathological examination, the prevalence of malignancy in clinical solitary thyroid nodules was 9.29% with male patients affected more than females (15% vs. 8.33%). Clinical assessment was a poor predictor for malignancy, as it was associated with a low sensitivity rate (69.23%), which means high false negative results, despite its high specificity rate (92.91%). According to the ultrasound examination, most malignancies were found in solid and mixed nodules (85% and 15%, respectively) with a significant association between the nature of nodules and malignancy potential. Fine-needle aspiration cytology was the most sensitive and specific investigation of thyroid nodules, it combined both high sensitivity and specificity for diagnosing malignant thyroid nodules (90.91% and 97.65%) respectively. Positive and negative predictive values were 79.83% and 99.06% respectively with an overall agreement of 97.02%.
Conclusion: Fine-needle aspiration cytology is a minimally invasive diagnostic tool for the early detection of malignancy among patients with solitary thyroid nodules, which combines high degrees of both specificity and sensitivity with a high accuracy rate of 97.02% comparable to histological examination.
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