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Rodríguez González, H. ., Pava Marín, R. ., Castaño Herrera, L. F. ., Valencia García, L. V. ., & Pava Ripoll, A. . (2017). Evaluación de la precisión diagnóstica de la punción aspiración con aguja fina en pacientes con nódulo tiroideo. Biosalud, 16(1), 11–18. https://doi.org/10.17151/biosa.2017.16.1.3
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La punción aspiración con aguja fina ha desempeñado un papel esencial en la evaluación del paciente con nódulo tiroideo, siendo un método rápido, mínimamente invasivo y de bajo costo. El objetivo de este estudio fue evaluar la precisión diagnóstica de la punción aspiración con aguja fina en lesiones tiroideas, contrastando sus resultados con los hallazgos histopatológicos obtenidos en la pieza quirúrgica. Materiales y métodos: Se realizó un análisis retrospectivo utilizando los sistemas de registro informático del Instituto Caldense de Patología en Manizales – Colombia. Se analizaron los casos estudiados por punción aspiración con aguja fina de tiroides entre enero del 2012 a febrero del 2014. El estudio incluyó 1220 casos, de los cuales a 111 se les realizó tiroidectomía, los resultados se correlacionaron y se determinó sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y precisión diagnóstica. Resultados: De los 111 casos, 5 se excluyeron por ser muestras insatisfactorias o atipias de significado indeterminado y quedaron 106 casos adecuados para la evaluación. La correlación citológica e histopatológica mostró una sensibilidad de 86,1%, especificidad de 88,2%, valor predictive positivo de 93,9%, valor predictivo negativo de 75% y una precisión diagnóstica de 86,7%. Discusión: La punción aspiración con aguja fina de tiroides es una prueba sensible, específica y con una buena precisión diagnóstica. Los datos obtenidos son comparables con los hallados en estudios previos similares.
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2. Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid. Arch Pathol Lab Med 2001; 125:484-8.DOI: 10.1043/0003-9985(2001)125<0484:AOFNAO>2.0.CO;2
3. Aysan E, Kiran T, Idiz UO, Guler B, Akbulut H, Kunduz E, et al. The diagnostic ability of core needle biopsy in nodular thyroid disease. Ann R Coll Surg Engl 2016; 00:1–4. DOI:10.1308/rcsann.2016.0331[In press]
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5. Mishra A, Mishra SK. Total thyroidectomy for differentiated thyroid cancer: primary compared with completion thyroidectomy. Eur J Surg 2002; 168:283-7. DOI:10.1002/ejs.47
6. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer Cytopathology 2007; 111:306-15. DOI:10.1002/cncr.22955
7. Mateša N, Tabain I, Dabelić N, Petric V, Kusić Z. Diagnostic relevance of fine-needle aspiration cytology for follicular lesions of the thyroid: retrospective study. Croat Med J 2002; 43:606-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/12402405
8. Bajaj Y, De M, Thompson A. Fine needle aspiration cytology in diagnosis and management of thyroid disease. J Laryngol Otol 2006; 120:467DOI: 10.1017/S0022215106000703
9. Baloch ZW, Fleisher S, LiVolsi VA, Gupta PK. Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol 2002; 26:41-4.DOI:
10.1002/dc.10043
10. Tseng CE, Wei CK, Kuo CS, Yan ST, Chen PF, Lien WC, et al. Fine needle aspiration cytology of thyroid nodules: evaluation of diagnostic accuracy. Tzu Chi Medical Journal 2008; 20:296-03. DOI:10.1016/S1016-3190(08)60054-3
11. Carrera CB, García-Díaz JD, Villaizán EM, Martínez-Onsurbe P, Torres NP, Vallejo PS. Eficacia diagnóstica de la punción-aspiración con aguja fina en pacientes con patología nodular tiroidea. Análisis de 510 casos. Revista Clínica Española 2005; 205:374-378. DOI: 10.1157/13078248
12. Khan I, Naz S, Akhter ZM, Aziz N. Diagnostic accuracy of fine needle aspiration of thyroid nodule verses biopsy in thyroid lesions. J Ayub Med Coll Abbottabad 2010; 22:179-181. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22455292#
13. Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proceedings 1994; 69:44-9. DOI: 10.1016/S0025-6196(12)61611-5
14. Orell SR, Sterrett GF, Walters MN, Whitaker D. Head and neck. In: Orell SR, Sterrett GF, Walters MN, Whitaker D. (Eds). Manual and Atlas of fine needle aspiration cytology. 3a Ed. Londres: Elsevier Science Limited; 1999. p. 110–44.
15. Ali, S.Z., & Cibas, E.S. The Bethesda system for reporting thyroid cytopathology: definitions, criteria and explanatory notes. Springer; 2010.
16. Nurismah MI, Sharifah NA, Usama AE, Rohaizak M, Naqiyah I, Jasmi A. Fine needle aspiration (FNA) cytology of thyroid: a cytohistopathological study of 361 cases in hospital university Kebangsaan Malaysia. Medicine & Health 2007; 2:58-65. Disponible en: http://www.medicineandhealthukm.com/fulltext/385
17. Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ Journal of Surgery 2003; 73:480-3. DOI: 10.1046/j.1445-1433.2003.02670.x
18. Jogai S, Al-Jassar A, Temmim L, Dey P, Adesina AO, Amanguno HG. Fine needle aspiration cytology of the thyroid: a cytohistologic study with evaluation of discordant cases. Acta Cytol 2005; 49:483-8.DOI: 10.1159/000326192
19. Cai XJ, Valiyaparambath N, Nixon P, Waghorn A, Giles T, Helliwell T. Ultrasound-guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules. Cytopathology 2006; 17:251-6. DOI: 10.1111/j.1365-2303.2006.00397.x
20. Cheung YS, Poon CM, Mak SM, Suen MW, Leong HT. Fine-needle aspiration cytology of thyroid nodules-how well are we doing? Hong Kong medical journal 2007; 13:12-15. Disponible en: http://www.hkmj.org/abstracts/v13n1/12.htm
21. Rubio V, Tamarit JM, Baviera N, Fernández S, Estrems P, Seijas T, López C, Dalmau J. (2009). Evaluación metodológica para detección de malignidad en patología quirúrgica tiroidea. Acta Otorrinolaringológica Española 2009; 60:390-395.DOI: 10.1016/j.otorri.2009.07.004
22. Swamy GG, Madhuravani S, Swamy GM. Fine needle aspiration cytology - a reliable diagnostic tool in the diagnosis of thyroid gland enlargements. Nepal Medical College Journal 2011; 13:289-292. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23016483
23. Sinna EA, Ezzat N. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions. Journal of the Egyptian National Cancer Institute 2012; 24:63-70. DOI: 10.1016/j.jnci.2012.01.001
24. Chala AI, Pava R, Franco HI, Álvarez A, Franco A. Criterios ecográficos diagnósticos de neoplasia maligna en el nódulo tiroideo: correlación con la punción por aspiración con aguja fina y la anatomía patológica. Rev Colombiana Cir 2013; 28:15-23. Disponible en: http://www.scielo.org.co/pdf/rcci/v28n1/v28n1a2.pdf
25. Prades JM, Querat C, Dumollard JM, Richard C, Gavid M, Timoshenko AA, Peoc’h M, Martin C. Thyroid nodule surgery: Predictive diagnostic value of fine-needle aspiration cytology and frozen section. European annals of otorhinolaryngology, head and neck diseases 2013; 130:195-199.DOI: 10.1016/j.anorl.2012.12.005
26. Naz S, Hashmi AA, Faridi N, Edhi MM, Kamal A, Khan M. Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective. International Archives of Medicine 2014; 7:46. DOI: 10.1186/1755-7682-7-46
27. Lee TI, Yang HJ, Lin SY, et al. The accuracy of fine-needle aspiration biopsy and frozen section in patients with thyroid cancer. Thyroid 2002; 12:619-26. DOI:10.1089/105072502320288492
28. Ahmeti I, Simonovska L, Krstevska B, Ristevska N. Fine Needle Aspiration in Thyroid Nodules - One Year Experience. OA Maced J Med Sci 2015; 3(2):307-309.DOI:10.3889/oamjms.2015.064
29. Ravetto C, Colombo L, Dottorini ME. Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer Cytopathology 2000; 90:357-63. DOI:10.1002/1097-0142(20001225)90:6<357::AID-CNCR6>3.0.CO;2-4
30. Werga P, Wallin G, Skoog L, Hamberger B. Expanding role of fine-needle aspiration cytology in thyroid diagnosis and management. World J Surg 2000; 24:907-12. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/10865034
31. Greaves TS, Olvera M, Florentine BD, Raza AS, Cobb CJ, Tsao-Wei DD, et al. Follicular lesions of thyroid. Cancer Cytopathology 2000; 90:335-41. DOI: 10.1002/1097-142 (20001225)90:6<335::AIDCNCR3>3.0.CO;2-L
2. Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid. Arch Pathol Lab Med 2001; 125:484-8.DOI: 10.1043/0003-9985(2001)125<0484:AOFNAO>2.0.CO;2
3. Aysan E, Kiran T, Idiz UO, Guler B, Akbulut H, Kunduz E, et al. The diagnostic ability of core needle biopsy in nodular thyroid disease. Ann R Coll Surg Engl 2016; 00:1–4. DOI:10.1308/rcsann.2016.0331[In press]
4. Abdul-Jaber HB, Lynn J. The surgical management of thyroid cancer. Nucl Med Commun 2004; 25:869-72. Disponible en: http://journals.lww.com/nuclearmedicinecomm/Citation/2004/09000/The_surgical_management_of_thyroid_cancer.2.aspx
5. Mishra A, Mishra SK. Total thyroidectomy for differentiated thyroid cancer: primary compared with completion thyroidectomy. Eur J Surg 2002; 168:283-7. DOI:10.1002/ejs.47
6. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer Cytopathology 2007; 111:306-15. DOI:10.1002/cncr.22955
7. Mateša N, Tabain I, Dabelić N, Petric V, Kusić Z. Diagnostic relevance of fine-needle aspiration cytology for follicular lesions of the thyroid: retrospective study. Croat Med J 2002; 43:606-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/12402405
8. Bajaj Y, De M, Thompson A. Fine needle aspiration cytology in diagnosis and management of thyroid disease. J Laryngol Otol 2006; 120:467DOI: 10.1017/S0022215106000703
9. Baloch ZW, Fleisher S, LiVolsi VA, Gupta PK. Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration cytology. Diagn Cytopathol 2002; 26:41-4.DOI:
10.1002/dc.10043
10. Tseng CE, Wei CK, Kuo CS, Yan ST, Chen PF, Lien WC, et al. Fine needle aspiration cytology of thyroid nodules: evaluation of diagnostic accuracy. Tzu Chi Medical Journal 2008; 20:296-03. DOI:10.1016/S1016-3190(08)60054-3
11. Carrera CB, García-Díaz JD, Villaizán EM, Martínez-Onsurbe P, Torres NP, Vallejo PS. Eficacia diagnóstica de la punción-aspiración con aguja fina en pacientes con patología nodular tiroidea. Análisis de 510 casos. Revista Clínica Española 2005; 205:374-378. DOI: 10.1157/13078248
12. Khan I, Naz S, Akhter ZM, Aziz N. Diagnostic accuracy of fine needle aspiration of thyroid nodule verses biopsy in thyroid lesions. J Ayub Med Coll Abbottabad 2010; 22:179-181. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22455292#
13. Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proceedings 1994; 69:44-9. DOI: 10.1016/S0025-6196(12)61611-5
14. Orell SR, Sterrett GF, Walters MN, Whitaker D. Head and neck. In: Orell SR, Sterrett GF, Walters MN, Whitaker D. (Eds). Manual and Atlas of fine needle aspiration cytology. 3a Ed. Londres: Elsevier Science Limited; 1999. p. 110–44.
15. Ali, S.Z., & Cibas, E.S. The Bethesda system for reporting thyroid cytopathology: definitions, criteria and explanatory notes. Springer; 2010.
16. Nurismah MI, Sharifah NA, Usama AE, Rohaizak M, Naqiyah I, Jasmi A. Fine needle aspiration (FNA) cytology of thyroid: a cytohistopathological study of 361 cases in hospital university Kebangsaan Malaysia. Medicine & Health 2007; 2:58-65. Disponible en: http://www.medicineandhealthukm.com/fulltext/385
17. Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules: how useful is it? ANZ Journal of Surgery 2003; 73:480-3. DOI: 10.1046/j.1445-1433.2003.02670.x
18. Jogai S, Al-Jassar A, Temmim L, Dey P, Adesina AO, Amanguno HG. Fine needle aspiration cytology of the thyroid: a cytohistologic study with evaluation of discordant cases. Acta Cytol 2005; 49:483-8.DOI: 10.1159/000326192
19. Cai XJ, Valiyaparambath N, Nixon P, Waghorn A, Giles T, Helliwell T. Ultrasound-guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules. Cytopathology 2006; 17:251-6. DOI: 10.1111/j.1365-2303.2006.00397.x
20. Cheung YS, Poon CM, Mak SM, Suen MW, Leong HT. Fine-needle aspiration cytology of thyroid nodules-how well are we doing? Hong Kong medical journal 2007; 13:12-15. Disponible en: http://www.hkmj.org/abstracts/v13n1/12.htm
21. Rubio V, Tamarit JM, Baviera N, Fernández S, Estrems P, Seijas T, López C, Dalmau J. (2009). Evaluación metodológica para detección de malignidad en patología quirúrgica tiroidea. Acta Otorrinolaringológica Española 2009; 60:390-395.DOI: 10.1016/j.otorri.2009.07.004
22. Swamy GG, Madhuravani S, Swamy GM. Fine needle aspiration cytology - a reliable diagnostic tool in the diagnosis of thyroid gland enlargements. Nepal Medical College Journal 2011; 13:289-292. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23016483
23. Sinna EA, Ezzat N. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions. Journal of the Egyptian National Cancer Institute 2012; 24:63-70. DOI: 10.1016/j.jnci.2012.01.001
24. Chala AI, Pava R, Franco HI, Álvarez A, Franco A. Criterios ecográficos diagnósticos de neoplasia maligna en el nódulo tiroideo: correlación con la punción por aspiración con aguja fina y la anatomía patológica. Rev Colombiana Cir 2013; 28:15-23. Disponible en: http://www.scielo.org.co/pdf/rcci/v28n1/v28n1a2.pdf
25. Prades JM, Querat C, Dumollard JM, Richard C, Gavid M, Timoshenko AA, Peoc’h M, Martin C. Thyroid nodule surgery: Predictive diagnostic value of fine-needle aspiration cytology and frozen section. European annals of otorhinolaryngology, head and neck diseases 2013; 130:195-199.DOI: 10.1016/j.anorl.2012.12.005
26. Naz S, Hashmi AA, Faridi N, Edhi MM, Kamal A, Khan M. Diagnostic accuracy of Bethesda system for reporting thyroid cytopathology: an institutional perspective. International Archives of Medicine 2014; 7:46. DOI: 10.1186/1755-7682-7-46
27. Lee TI, Yang HJ, Lin SY, et al. The accuracy of fine-needle aspiration biopsy and frozen section in patients with thyroid cancer. Thyroid 2002; 12:619-26. DOI:10.1089/105072502320288492
28. Ahmeti I, Simonovska L, Krstevska B, Ristevska N. Fine Needle Aspiration in Thyroid Nodules - One Year Experience. OA Maced J Med Sci 2015; 3(2):307-309.DOI:10.3889/oamjms.2015.064
29. Ravetto C, Colombo L, Dottorini ME. Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer Cytopathology 2000; 90:357-63. DOI:10.1002/1097-0142(20001225)90:6<357::AID-CNCR6>3.0.CO;2-4
30. Werga P, Wallin G, Skoog L, Hamberger B. Expanding role of fine-needle aspiration cytology in thyroid diagnosis and management. World J Surg 2000; 24:907-12. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/10865034
31. Greaves TS, Olvera M, Florentine BD, Raza AS, Cobb CJ, Tsao-Wei DD, et al. Follicular lesions of thyroid. Cancer Cytopathology 2000; 90:335-41. DOI: 10.1002/1097-142 (20001225)90:6<335::AIDCNCR3>3.0.CO;2-L
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