PREOPERATIVE TESTS AND HISTOPATHOLOGICAL FINDINGS IN THYROID NODULE SUGERY. A CORRELATION STUDY.

AUTHORS:
J. García Cardo (Santander, Spain) , G. Gutiérrez Fernández (Santander, Spain) , E. García Somacarrera (Santander, Spain) , A. Lopez Useros (Santander, Spain) , C. García Rodriguez-Maimón (Santander, Spain) , D. Ceniza Pena (Santander, Spain) , S. Castanedo Bezanilla (Santander, Spain) , E. Toledo Martínez (Santander, Spain) , E. Lagunas Caballero (Santander, Spain) , E.J. Anderson (Santander, Spain)
Background:
Preoperative predictors could guide the need and type of surgery. The aim of the study is to correlate preoperative tests with histopathological findings in thyroid nodule surgery.
Methods:
Patients from a prospective database who underwent surgery for a thyroid nodule between 2009 and 2022, were retrospectively analysed. A descriptive analysis was performed with demographics, ultrasound result (US) (EU-TIRADS system), fine needle aspiration cytology result (FNAC) (Bethesda system), size of the suspicious nodule and histopathological findings. The positive predictive value (PPV) of US, FNAC, and an analysis of the risk factors related to the tumor were also determined.
Results:
a total of 718 patients were analysed, 560 (77.99%) of them were female and the median age was 51 years. 130 tumours (18.11%) were discovered. The PPV of US (TIRADS 3, 4 and 5) was 13.9%, 40% and 57.1% respectively. Regarding the FNAC, (Bethesda III, IV, V, VI) the PPV was 16,1%, 23%, 81,1% and 80% respectively. Associating a higher TIRADS value increased the PPV in Bethesda IV nodules. Larger nodule size was inversely related to the likelihood of cancer diagnosis (p<0.001), both in the overall analysis and in the Bethesda IV subgroup. Male sex was associated with a higher cancer diagnosis (p<0.003). No differences were found regarding age.
Conclusions:
In our series, US and FNAC did not have a high PPV in the diagnosis of thyroid cancer, although associating both results increased the value. Smaller size and male sex were associated with a higher probability diagnosis of thyroid cancer.