Ultrasound-guided fine needle aspiration of thyroid nodules with on-site cytological examination: Diagnostic efficacy, prevalence, and factors predicting for Bethesda category I results

• Published in: Endocrinología, diabetes y nutrición. diabetes y nutrición., 2019-10, Vol.66 (8), p.495-501
• Main Authors: García Pascual, Luis, Surralles, Maria Lluïsa, Morlius, Xavier, González Mínguez, Clarisa, Viscasillas, Guillem, Lao, Xavier
• Format: Article
• Language: English
• Subjects: Bethesda; Citología; Cytology; Fine-needle aspiration cytology; Nódulo tiroideo; Punción-aspiración con aguja fina; Thyroid nodule
• ISSN: 2530-0180; 2530-0180
• DOI: 10.1016/j.endien.2018.12.007

Ultrasound-guided fine needle aspiration of thyroid nodules with on-site cytological examination may decrease the number of Bethesda category I cytologies. The study objective was to evaluate our second-year experience with this procedure to analyze diagnostic efficacy, prevalence, and factors predicting for Bethesda category I results. A retrospective study was conducted of 279 nodules from 233 patients. Ultrasound-guided fine needle aspiration was performed according to the 2015 criteria of the American Thyroid Association. A specimen of each aspiration was air-fixed on site before Diff-Quik staining and microscopic examination to assess its suitability; otherwise, nodule aspiration was repeated up to 5 times. Diagnostic efficacy was assessed based on sensitivity and specificity on the cytological categories Bethesda II and Bethesda VI. Diagnostic sensitivity and specificity were both 100%, 5.4% Bethesda category I results were obtained, and variables independently associated were age (4.7% increase per year of life) and nodule volume (2.3% increase per each 1ml of volume). Ultrasound-guided fine needle aspiration of thyroid nodules with on-site cytological examination allows for a high diagnostic efficacy and has been shown to be a highly relevant procedure because it has a very low rate of cytological results of Bethesda category I, whose risk has been higher in older subjects and with larger nodules. El procedimiento de punción-aspiración con aguja fina ecoguiada de nódulos tiroideos con examen citológico in situ del material extraído puede reducir el número de citologías obtenidas de categoría Bethesda I. El objetivo del estudio ha sido evaluar nuestra experiencia del segundo año en dicha técnica para analizar la eficacia diagnóstica, la prevalencia y los factores predictores de los resultados de categoría Bethesda I. Estudio retrospectivo sobre 279 nódulos en 233 pacientes. La punción-aspiración se realizó según los criterios de 2015 de la American Thyroid Association. Una muestra de cada punción se fijó al aire y se procesó in situ mediante tinción con Diff-Quik y examen microscópico para valorar su idoneidad; en caso contrario, se repitió la punción hasta un total de 5veces. La eficacia diagnóstica se valoró en base a la sensibilidad y a la especificidad sobre las categorías citológicas Bethesda II y Bethesda VI. La sensibilidad y la especificidad diagnóstica fueron del 100% en ambos casos. Obtuvimos un 5,4% de resultados de categoría Bethesda I y