ABSTRACT
Introducción y objetivo La enfermedad nodular tiroidea es un proceso frecuente en nuestra práctica clínica y la punción-aspiración con aguja fina (PAAF) es la técnica diagnóstica de elección. Su mayor limitación es la prevalencia de muestras no diagnósticas. Desde la implantación en 2007 de los criterios de Bethesda (documento de consenso sobre los criterios morfológicos y la terminología diagnóstica en la interpretación de las extensiones citológicas de tiroides) se demostró en nuestro servicio una mayor prevalencia de PAAF no diagnósticas. Decidimos añadir a la técnica habitual la recogida y el centrifugado del material remanente en las agujas de punción mediante lavado en una solución ThinPrep® y evaluar el aumento de la rentabilidad diagnóstica de la PAAF tras este cambio. Pacientes y métodos Muestreo sistemático de 168 pacientes a los que se realizó una PAAF en el Servicio de Endocrinología y Nutrición del Hospital Xeral-Cíes de Vigo desde enero de 2010 hasta noviembre (..) (AU)
Background and objective Nodular thyroid disease is a common condition in our clinical practice, and fine needle aspiration biopsy (FNAB) is the diagnostic procedure of choice. Its main limitation is the number of non-diagnostic samples. Since the Bethesda criteria were implemented in 2007 (a consensus document on the morphologic criteria and diagnostic terminology for interpretation of thyroid cytological samples), a higher prevalence of non-diagnostic FNAB was shown. In addition to the standard technique, we decided to collect and centrifuge the material remaining in puncture needles by washing them in a ThinPrep® solution, and to assess the increase in the diagnostic yield of FNAB after this change. Patients and methods Systematic sampling of 168 patients who underwent FNAB at the Nutrition and Endocrinology Department of the Xeral-Cies Hospital (Vigo, Spain) from January 2010 to November 2011. Patients were classified into 2 groups: 75 patients in whom the residual material in the needle was not collected (non-washing group) and 93 patients in whom the material was collected (washing-group). All FNABs were performed by the same endocrinologist. Data are shown as percentage (± standard error) for ordinal variables or as mean (± standard deviation) for quantitative variables. A Chi-square test was used for statistical analysis (..) (AU)
Subject(s)
Humans , Thyroid Neoplasms/pathology , Biopsy, Fine-Needle/methods , Thyroid Nodule/pathology , Biopsy, Fine-Needle/instrumentation , Cytological Techniques/methodsABSTRACT
BACKGROUND AND OBJECTIVE: Nodular thyroid disease is a common condition in our clinical practice, and fine needle aspiration biopsy (FNAB) is the diagnostic procedure of choice. Its main limitation is the number of non-diagnostic samples. Since the Bethesda criteria were implemented in 2007 (a consensus document on the morphologic criteria and diagnostic terminology for interpretation of thyroid cytological samples), a higher prevalence of non-diagnostic FNAB was shown. In addition to the standard technique, we decided to collect and centrifuge the material remaining in puncture needles by washing them in a ThinPrep(®) solution, and to assess the increase in the diagnostic yield of FNAB after this change. PATIENTS AND METHODS: Systematic sampling of 168 patients who underwent FNAB at the Nutrition and Endocrinology Department of the Xeral-Cies Hospital (Vigo, Spain) from January 2010 to November 2011. Patients were classified into 2 groups: 75 patients in whom the residual material in the needle was not collected (non-washing group) and 93 patients in whom the material was collected (washing-group). All FNABs were performed by the same endocrinologist. Data are shown as percentage (± standard error) for ordinal variables or as mean (± standard deviation) for quantitative variables. A Chi-square test was used for statistical analysis of comparisons between percentages, and a Student's t test for comparisons between quantitative variables. A value of p<0.05 was considered statistically significant. RESULTS: No significant differences were found between the groups in age, sex, plasma TSH levels or nodule size. The rate of non-diagnostic FNABs was 44% (± 0.06) in the non-washing group and 17.2% (± 0.04%) in the washing group, with a significant difference (p < 0.01). DISCUSSION: Collection and subsequent processing of the residual material in the needle after FNAB significantly decreased the prevalence of non-diagnostic punctures in our patients. Collection of the residual material in the needle in this way is strongly recommended.
