Correlación entre estudio citológico y estudio histopatológico en el diagnóstico de Neoplasia Tiroidea. SOLCA - Cuenca. 2009- 2013

Abstract

Background. Thyroid neoplasm increasing, drives the search for diagnostic methods with sensitivity and reliable specificity for early advice and treatment to enable longer survival and better quality of life for patients. Cytology method FNA gives a real approximation of malignancy or benign thyroid neoplasia, you can specify the type of cancer, but does not replace histopathological study that defines carcinoma type. Objective: correlating cytology according to the Bethesda system, FNA method histopathology for diagnosis of thyroid neoplasia. Methodology: in retrospective observational design time information from medical records on thyroid punctures from 2009-2013 in SOLCA, Cuenca, Ecuador was collected. Results: the sample comprised 415 patients with thyroid neoplasm were characterized by 89.2% women and an average age of 51.8 ± 15.2 years. 47.2% of patients come from Cuenca and 37.8% of neighboring provinces. 96.4% (188 of 195) of Bethesda cytologic diagnosis category 6 (malignancy) were confirmed by histology. There was correlation (r = 0.49) and significantly moderate agreement (kappa = 0.337) between cytology and histology. The sensitivity was 63% (95% CI 58-69), specificity of 94% (95% CI 89-98), likelihood ratio + 10.9 (95% CI 5-22) and the likelihood ratio - 0.39 (95% 0.3 to 0.4). Conclusion: puncture fine needle aspiration is a valuable diagnostic tool. A puncture made by skilled hands is fast, economical, well tolerated technique, is performed as outpatients and produces samples with reliable results. Bethesda categorization represents a reliable and valid thyroid cytology reporting system