FEATURES OF THE DIAGNOSIS AND TREATMENT OF PATIENTS WITH SMALL TUMORS OF THE THYROID GLAND

Abstract

Summary. Aim: to identify the causes of diagnostic errors at the preoperative stage in patients with thyroid nodules measuring < 1.0 cm. Object and methods: the study consists of retrospective and prospective research based on the analysis of examination results of 4509 patients with focal lesions of the thyroid gland. All patients underwent a comprehensive examination (ultrasound, fineneedle aspiration biopsy + cytological examination) in 872 patients with nodules of the thyroid gland measuring < 1.0 cm. The data of histopathological, cytological, and ultrasound findings were compared, and the accuracy, sensitivity, and specificity of ultrasound (US) and fineneedle aspiration biopsy (FNAB) under US control in the diagnosis of thyroid nodules with a diameter < 1.0 cm, including microcarcinoma, were evaluated. Results: out of 1003 cases of thyroid nodules, a correct preoperative US conclusion was formulated in 838 cases (83.6%) relative to postoperative histological examination, incorrect interpretation of the ultrasound image was noted in 165 cases (16.5%), with false-positive results in 85 cases (8.5%) and false-negative results in 80 (8.0%). The sensitivity of US for thyroid nodules measuring < 1 cm was 73.9%, and specificity was 82%. In 159 cases (94.6%) out of 168 patients with verified thyroid nodules, cytological examination data (papillary, follicular, or medullary thyroid carcinoma) corresponded to histological findings. The sensitivity of FNAB for thyroid nodules in less than centimeter sizes was 89.7%, and the specificity for benign less than centimeter thyroid nodules was 83.4%. Conclusions: ultrasound remains the standard for visualizing thyroid nodules, so clear criteria for their assessment will significantly reduce the number of nodules requiring biopsy and help clinicians improve the accuracy of treatment recommendations.