Tiroid Nodülü Olan Çocuklarda Laboratuvar, Radyolojik ve Sitopatolojik Değerlendirmelerin Histopatolojik Sonuçlarla İlişkisi
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Tarih
2021
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info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: Çocuklarda, tiroid nodüllerinde malignite saptanma sıklığı erişkinlerden daha yüksektir. Çalışmamızda tiroid nodülü olan çocuklarda malign nodülleri saptamada etkili faktörlerin belirlenmesi amaçlandı. Gereç ve Yöntem: Çalışmamız retrospektif, tek merkezli bir çalışmadır. Tiroid ince iğne aspirasyon biyopsisi (İİAB) uygulanan <19 yaş 92 hastanın yaş, cinsiyet, laboratuvar, görüntüleme, sitopatoloji ve cerrahi patoloji verileri kaydedildi. Sitopatolojisi benign olan hastalar benign dışı (Bethesda 3-6) olanlarla ve patolojisi malign olan hastalar benign olanlarla yaş, cinsiyet, laboratuvar ve ultrasonografi bulguları açılarından karşılaştırıldı. Bulgular: İİAB sonuçları %14,1 (13/92) tanısal olmayan, %67,4 (62/92) benign, %7,6 (7/92) önemi belirsiz atipi veya folliküler lezyon, %7,6 (7/92) folliküler tümör veya şüphesi, %2,2 (2/92) malignite şüphesi ve %1,1 (1/92) malign şeklindeydi. Benign dışı sitolojisi olanlarda nötrofil/lenfosit oranı (NLO) ve solid nodül sıklığı daha yüksekti (sırasıyla p=0,042, p=0,014). Patolojik incelemesi olan hastaların (n=21) 5’inde karsinom, 2’sinde malignite potansiyeli belirsiz tümör, 14’ünde benign durumlar saptandı. Tüm hastalar içinde malignite sıklığı %5,4 olarak saptandı. Malign patoloji saptananlarda tanı yaşı ortalaması daha düşük, NLO ve solid nodül sıklığı ise daha yüksek bulundu (sırasıyla p=0,042; p=0,016; p=0,026). İİAB’nin malign nodülü saptamadaki duyarlılığı %100, özgüllüğü %53,8, tanısal değeri %66,7 olarak belirlendi. Sonuç: NLO yüksekliği ve nodülün solid oluşu İİAB’de benign dışı sonuçlara ve histopatolojide maligniteye işaret edebilir. Tanı yaşı küçük olgularda malignite riski daha yüksek olabilir. İİAB, çocuklarda malign nodülleri saptamada yüksek hassasiyettedir, ancak özgüllüğü artırmaya yönelik çalışmalara ihtiyaç vardır.
Öz: Objectives: In children, the frequency of malignancy in thyroid nodules is higher than in adults. The aim of our study was to determine the effective factors in assigning malignant nodules in children with thyroid nodule. Materials and Methods: This is a retrospective, single-center study. Age, gender, laboratory, radiological, cytopathological and pathological data of 92 patients who were <19 years old and who underwent fine needle aspiration biopsy (FNAB) were recorded. Patients with benign and nonbenign (Bethesda 3-6) cytopathologies, and also patients with malign and benign pathologies were compared in terms of age, gender, laboratory and radiological findings. Results: FNAB cytopathologies were reported as 14.1% (13/92) non-diagnostic, 67.4% (62/92) benign, 7.6% (7/92) atypia or follicular lesion of undetermined significance, 7.6% (7/92) follicular neoplasia or its suspicion, 2.2% (2/92) suspected malignancy, and 1.1% (1/92) malignant. Neutrophil/lymphocyte ratio (NLR) and the frequency of solid nodules were higher in patients with non-benign cytology (p=0.042, p=0.014, respectively). Pathological examinations (n=21) revealed five carcinomas, two neoplasias with undetermined malignant potential, and 14 benign conditions. The frequency of overall malignancy was 5.4%. The mean age at diagnosis was lower; NLR and the frequency of solid nodules were higher in those with malignant pathology (p=0.042; p=0.016; p=0.026, respectively). The sensitivity of FNAB in detecting malignant nodule was 100%, specificity was 53.8%, and its diagnostic value was 66.7%. Conclusion: High NLR and solid nodule may indicate non-benign results in FNAB and malignant histopathology. The risk of malignancy may be higher in cases of younger age at diagnosis. FNAB has high sensitivity in detecting malignant nodules in children; however, studies are needed to increase specificity.
Öz: Objectives: In children, the frequency of malignancy in thyroid nodules is higher than in adults. The aim of our study was to determine the effective factors in assigning malignant nodules in children with thyroid nodule. Materials and Methods: This is a retrospective, single-center study. Age, gender, laboratory, radiological, cytopathological and pathological data of 92 patients who were <19 years old and who underwent fine needle aspiration biopsy (FNAB) were recorded. Patients with benign and nonbenign (Bethesda 3-6) cytopathologies, and also patients with malign and benign pathologies were compared in terms of age, gender, laboratory and radiological findings. Results: FNAB cytopathologies were reported as 14.1% (13/92) non-diagnostic, 67.4% (62/92) benign, 7.6% (7/92) atypia or follicular lesion of undetermined significance, 7.6% (7/92) follicular neoplasia or its suspicion, 2.2% (2/92) suspected malignancy, and 1.1% (1/92) malignant. Neutrophil/lymphocyte ratio (NLR) and the frequency of solid nodules were higher in patients with non-benign cytology (p=0.042, p=0.014, respectively). Pathological examinations (n=21) revealed five carcinomas, two neoplasias with undetermined malignant potential, and 14 benign conditions. The frequency of overall malignancy was 5.4%. The mean age at diagnosis was lower; NLR and the frequency of solid nodules were higher in those with malignant pathology (p=0.042; p=0.016; p=0.026, respectively). The sensitivity of FNAB in detecting malignant nodule was 100%, specificity was 53.8%, and its diagnostic value was 66.7%. Conclusion: High NLR and solid nodule may indicate non-benign results in FNAB and malignant histopathology. The risk of malignancy may be higher in cases of younger age at diagnosis. FNAB has high sensitivity in detecting malignant nodules in children; however, studies are needed to increase specificity.
Açıklama
Anahtar Kelimeler
Kaynak
Ankara Üniversitesi Tıp Fakültesi Mecmuası
WoS Q Değeri
Scopus Q Değeri
Cilt
74
Sayı
1
Künye
ÇAMTOSUN E,AKINCI A,ÇİFTÇİ N,GÖKÇE H,KAYAŞ L (2021). Tiroid Nodülü Olan Çocuklarda Laboratuvar, Radyolojik ve
Sitopatolojik Değerlendirmelerin Histopatolojik Sonuçlarla İlişkisi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 74(1), 68 - 75. Doi: 10.4274/atfm.galenos.2020.30922
