Correlación entre el estudio citológico e histopatólógico en el diagnóstico de carcinoma diferenciado de tiroides
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: El carcinoma diferenciado de tiroides (CDT) comprende 1% de todos los carcinomas y es la neoplasia maligna endócrina más común. El estándar de oro en diagnóstico de nódulo tiroideo, además de ecografía, es el estudio histopatológico, pero la punción aspiración con aguja fina (PAAF) es simple, segura y tiene altas tasas de especificidad y sensibilidad. Es importante establecer el grado de concordancia entre ambos métodos, para tomar decisiones terapéuticas adecuadas. Objetivo: Determinar la correlación entre el estudio citológico e histopatológico en diagnóstico de CDT. Metodología: El estudio es tipo descriptivo, correlacional, no experimental y de corte transversal; incluyó 237 pacientes con sospecha de cáncer de tiroides (CT) de consulta externa de Endocrinología del hospital “Teodoro Maldonado Carbo” en Guayaquil periodo enero 2016 a diciembre 2017. Resultados: El diagnóstico con PAAF, según el Sistema Bethesda (SB) encontró 144 pacientes con CDT, correspondiendo a la categoría IV 14,8%, V 13,5% y VI 32,5% del total. El carcinoma papilar representó 96% del total y el carcinoma folicular solo 4%. El examen histopatológico reportó 204 pacientes (86,1%) con CDT. La evaluación de los métodos diagnósticos demostró una sensibilidad del 67,2%, especificidad 78,8%, fiabilidad 69%. VPP 95%, VPN 27%. Conclusión: El estudio citológico con el SB es el método aceptable para predecir que un paciente tiene CT, pero es cuestionable para predecir que no lo tiene. El estudio citológico, mediante la PAAF, si tiene concordancia diagnóstica con el estudio histopatológico en el CDT.
Introduction: Differentiated thyroid carcinoma (CDT) comprises 1% of all carcinomas and is the most common endocrine malignant neoplasia. The gold standard in thyroid nodule diagnosis, in addition to ultrasound, is histopathological study, but fine needle aspiration (FNA) is simple, safe and has high rates of specificity and sensitivity. It is important to establish the degree of concordance between the two methods to make appropriate therapeutic decisions. Objective: To determine the correlation between the cytological and histopathological study in CDT Diagnostics. Methodology: The study is descriptive, correlational, non-experimental and cross-sectional; included 237 patients with suspected thyroid cancer (CT) external endocrinology consultation of the hospital “Teodoro Maldonado Carbo” in Guayaquil period January 2016 to December 2017. Results: The diagnosis with FNA, according to the Bethesda (SB) System found 144 patients with CDT, corresponding to category IV 14.8%, V 13.5% and VI 32.5% of the total. Papillary carcinoma represented 96% of total and follicular carcinoma only 4%. The histopathological examination reported 204 patients (86.1%) with CDT. The evaluation of the diagnostic methods showed a sensitivity of 67.2%, specificity 78.8%, reliability 69%. VPP 95%, VPN 27%. Conclusion: Cytologic study with SB is the acceptable method of predicting that a patient has CT, but is questionable to predict that he does not have it. The cytologic study, through FNA, if it has diagnostic concordance with histopathological study in the CDT.
Introduction: Differentiated thyroid carcinoma (CDT) comprises 1% of all carcinomas and is the most common endocrine malignant neoplasia. The gold standard in thyroid nodule diagnosis, in addition to ultrasound, is histopathological study, but fine needle aspiration (FNA) is simple, safe and has high rates of specificity and sensitivity. It is important to establish the degree of concordance between the two methods to make appropriate therapeutic decisions. Objective: To determine the correlation between the cytological and histopathological study in CDT Diagnostics. Methodology: The study is descriptive, correlational, non-experimental and cross-sectional; included 237 patients with suspected thyroid cancer (CT) external endocrinology consultation of the hospital “Teodoro Maldonado Carbo” in Guayaquil period January 2016 to December 2017. Results: The diagnosis with FNA, according to the Bethesda (SB) System found 144 patients with CDT, corresponding to category IV 14.8%, V 13.5% and VI 32.5% of the total. Papillary carcinoma represented 96% of total and follicular carcinoma only 4%. The histopathological examination reported 204 patients (86.1%) with CDT. The evaluation of the diagnostic methods showed a sensitivity of 67.2%, specificity 78.8%, reliability 69%. VPP 95%, VPN 27%. Conclusion: Cytologic study with SB is the acceptable method of predicting that a patient has CT, but is questionable to predict that he does not have it. The cytologic study, through FNA, if it has diagnostic concordance with histopathological study in the CDT.
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Neoplasias de la tiroides, Biopsia con aguja fina, Biología celular, Patología, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador, Correlación de datos, Patología, Histopatología