ASSESSMENT OF THE POTENTIAL OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN THE DIAGNOSIS OF TUMOR AT A PUBLIC MEDICAL COLLEGE HOSPITAL IN BANGLADESH

Abstract

We determined the sensitivity, specificity, positive and negative predictive values of physical examination and fine needle aspiration cytology (FNAC) for diagnosis of tumor’s, considering histopathology as standard that included fifty suspected tumor patients. Following the completion of interview for clinical history and physical examination, FNAC and histopathology were performed. Lump was present in 44% cases, weight loss was observed in 42% cases as complaint signs and pain occurred at the site of tumor in 44% cases. Physical examination indicated that 36% cases were malignant and 64% were benign tumors. Histopathological diagnosis of the tumor confirmed that 46% cases were malignant and 54% were benign. Thus, physical examination was sensitive in 52.11%, specific in 77.78%, accurate in 76% and the negative and positive predictive values were 34.37% and 66.57%, respectively. However, FNAC showed 72% neoplasm and 28% non-neoplasm, while histopathology revealed 86% neoplasm and 14% non neoplasm among the patients. So, the sensitivity, specificity, accuracy, false positive and false negative results , positive and negative predictive values of FNAC were 62.50%, 88.46%, 76%, 16.67%, 28.12%, 83.33% and 71.88%, respectively. Particularly in 28% non-neoplasm’s, FNAC showed equal accuracy and sensitivity and that was 50%. In correlation with 27 benign cases and 23 malignant tumors from histopathology, FNAC showed accuracy of 92.60% and 43.48%, respectively. Though FNAC is less sensitive than histopathology in making unequivocal diagnosis of cancer but insignificantly different from histopathology in interpreting atypical or malignant cases of tumors.