BOZOK ÜNİVERSİTESİ'NDE İNCELENEN TİROİD İNCE İGNE ASPİRASYONLARININ ANALİZİ, TANISAL DEGERİ VE DOGRULUGU The Analysis, Diagnostic Value and Accuracy of Thyroid Fine Needle Aspirations Evaluated at Bozok University

Abstract

Amac: Bu calismada Bozok Universitesi Tip Fakultesi'nde degerlendirilen tiroid ince igne aspirasyonu (TIIA) ile ilgili deneyimlerimizi gozden gecirmek, TIIA'nin tanisal degeri ve dogrulugunu istatistiksel olarak belirlemek ve verilerin literatur ile korelasyonunu yapmak amaclanmistir. Metod: Bozok Universitesi Tip Fakultesi Tibbi Patoloji Anabilim Dali'nda Eylul 2012-Agustos 2014 tarihleri arasinda degerlendirilen 636 olguya ait TIIA Bethesda raporlama sistemine gore retrospektif olarak incelen- mistir. Ayrica postoperatif histopatolojik tanilari bulunan 29 olgunun TIIA tanilari ile korelasyonu yapilmis ve aralarindaki uyum arastirilmistir. Bulgular: Calismada 636 olguya ait 698 TIIA degerlendirilmistir. Olgularin 545'i kadin, 91'i erkektir. Yas ortala- masi 48.9, yas araligi 17-81'dir. TIIA'larin 491'i benign, 170'i nondiagnostik yayma, 12'si follikuler neoplazi/fol- likuler neoplazi suphesi, 10'u malignite suphesi, 9'u onemi belirsiz atipi/onemi belirsiz follikuler lezyon (AUS/ FLUS), 6'si malign tanisi almistir. Postoperatif histopatolojik tanilari bulunan 29 olguda TIIA'nin gercek pozitiflik orani %20, gercek negatiflik orani %44, yalanci negatiflik ve yalanci pozitiflik oranlari %16, sensitivitesi ve po- zitif prediktif degeri %55.6, spesifisitesi ve negatif prediktif degeri %73.3, tanisal dogruluk orani %64 olarak hesaplanmistir. Sonuc: TIIA kolay uygulanabilen, minimal invaziv, ucuz ve tanisal dogruluk orani yuksek bir tani yontemidir. Daha yuksek tanisal deger elde edilmesinde teknik olarak uygun alinmis sitolojik materyalin, patologun TIIA alanindaki tecrubesinin ve bilgisinin yani sira iyi bir klinikopatolojik korelasyonun onemli oldugu akilda tutul- malidir. Anahtar kelimeler: Ince igne aspirasyonu; Sitoloji; Tiroid. ABSTRACT Objective: The aim of the study was to analyze the diagnostic value and accuracy of the thyroid fine needle aspiration (TFNA) evaluated at Bozok University Medical Faculty statistically and correlate the data with the literature. Method: 636 TFNAs examined between September 2012-August 2014 at the Pathology Department of Bozok University Medical Faculty were analyzed retrospectively according to the Bethesda reporting system. Also, the 29 cases that had histopathological diagnoses were correlated with the TFNA diagnoses, and the diagnostic accuracy was evaluated. Results: 698 TFNAs from 636 cases were evaluated in the study. 545 of the cases were female, 91 were male. The mean age was 48.9, the range was 17-81 years. 491 of the TFNAs were reported as benign, 170 were as nondiagnostic aspirate, 12 were as follicular neoplasm/suspicious for follicular neoplasm, 10 were as suspicious for malignancy, 9 were as atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), and 6 were as malignant. Among 29 cases that had postoperative histopathologic diagnoses, true-positivity of TFNA was %20, true- negativity was %44, false negativity and false positivity were %16, sensitivity and positive predictive value were %55.6, specifity and negative predictive value were %73.3, diagnostic accuracy was %64. Conclusion: TFNA is an easily applicable, minimally invasive, cost-effective diagnostic method that has high diagnostic accuracy. it should be noted that technically adequate cytological material, the experience and knowledge of the pathologist about TFNA, and a comprehensive clinicopathological correlation are necessary for obtaining a higher diagnostic value. Key words: Fine needle aspiration; Cytology; Thyroid