CORRELACIÓN ENTRE LA BIOPSIA ASPIRACIÓN CON AGUJA FINA Y LA BIOPSIA POR CONGELACIÓN INTRAOPERATORIA EN EL DIAGNÓSTICO Y MANEJO QUIRÚRGICO DEL NÓDULO TIROIDEO EN EL SERVICIO DE CIRUGÍA DEL INSTITUTO ONCOLÓGICO NACIONAL “SOCIEDAD DE LUCHA CONTRA EL CÁNCER” (ION – SOLCA) GUAYAQUIL, DURANTE EL PERIODO 01 DE MAYO DEL 2014 AL 31 DE MAYO DEL 2016

Abstract

Background: Despite advances in the diagnostic tools used, identification of malignant thyroid nodules remains a challenge for pathologists, endocrinologists, and surgeons. There is controversy over the use of fine needle biopsy (FNB) and freezing biopsy (FB) to be elucidated by this study. Aim: To determine the diagnostic correlation between FNAB and BCIO; the sensitivity and specificity of both, leading to a more rational use of these diagnostic tests, optimizing resources and reducing costs. Methods: A prospective study involving 128 patients who underwent surgery for thyroid nodules, who underwent FNB and FB, from May 2014 to May 2016. In the FNB, the malignant pattern was Bethesda 6. The sections of FNB, FB and paraffin blocks, the gold standard being the paraffin block. Results: Of 128 patients, 117 (91.4%) women and 11 (8.6%) men, with mean age of 47 years; 77 (60.2%) had benign lesions and 51 (38.8%) had malignant lesions, 38.5% (45/117) of women had cancer and 54.5% (6/11) men, with papillary carcinoma predominating in 88.2 %. The FNB and FB reported a separate sensitivity of 54.90%, 93.48%, specificity 98.70%, 98.59%, and diagnostic concordance 81.25%, 96.58% respectively; Bethesda 5 being 50% (5/10) malignant. The FNB and FB together reported a sensitivity of 93.75%, specificity 95.83%, and diagnostic concordance 90%. The surgical reintervention if only BCIO would be performed would be 6.3% (8/128), and when the two diagnostic procedures were applied, it was reduced to 4.7% (6/128), with an unnecessary radical thyroidectomy increase of 0, 8% to 1.6% respectively. Conclusions: FNB is a reliable method with high specificity to diagnose malignancy in thyroid pathology; with results indicating Bethesda 3, 4, 5 and even 2 BCIO is very useful and can reduce surgical reoperations and unnecessary radical thyroidectomies.