Vacuum fine-needle aspiration biopsy as a method of early detection of thyroid cancer

Abstract

Relevance. Malignant neoplasms of the thyroid gland account for 1–3% in the structure of oncological pathology in the territory of the Russian Federation. Fine needle aspiration biopsy of thyroid foci is an integral part of the examination and is included in both foreign and domestic recommendations. However, there is a problem of obtaining uninformative cytological conclusions, and the risk of obtaining false positive and false negative results remains.Objective. To determine the possibilities of using vacuum aspiration fine needle biopsy under ultrasound control in patients with focal thyroid pathology in a multidisciplinary hospital.Materials and methods. From 2021 to 2023, 331 patients with focal thyroid pathology were examined at the clinical base of the Department of Diagnostic and Minimally Invasive Technologies of the Clinical Hospital № 1 in Smolensk. All patients were divided into two clinical groups. Patients of both groups underwent a comprehensive examination, including palpation of the thyroid gland and lymph nodes of the neck, multiparametric ultrasound examination of the thyroid gland, including B – mode, color Doppler mapping, compression elastography, shear wave elastography, laboratory examination (calcitonin level, TSH, T3, T4, antibodies of TPO, AtTTP, thyroglobulin). In patients who had previously undergone surgical treatment, ultrasound was performed to determine areas of thyroid tissue, and additionally the level of thyroglobulin was determined as a marker of the recurrent process.Results. The median size of the thyroid formation was 15.2 (13.9–19.1) mm. Mainly multiple foci of thyroid gland were detected in both the control group – 106 (79.1%) and the main 107 (54.3%) patients, the share of single foci accounted for 28 (20.9%) of the control and 90 (45.7%) of the main groups. Fine – needle aspiration biopsy was performed using the «Free hand» method using type syringe with a volume of 10 ml. During the vacuum fine – needle aspiration biopsy, depending on the data of the multiparametric ultrasound examination, the level of negative pressure in the range from –0.3 bar to –0.8 bar was determined. At a pressure of –0.3 bar, 54 (27.4%) were performed,–0.5 bar – 126 (64.0%),–0.8 bar – 17 (8.6%) vacuum fine – needle aspiration biopsy.Conclusions. A device has been developed for the implementation of vacuum fine – needle aspiration biopsy with the creation of an improved technique for conducting vacuum fine – needle aspiration biopsy in focal thyroid pathology. The informative value of the method of routine fine – needle aspiration biopsy and vacuum fine – needle aspiration biopsy under ultrasound control in patients with focal thyroid pathology was evaluated. The sensitivity and specificity of fine – needle aspiration biopsy was 75.0% and 52.9%, respectively. The sensitivity and specificity of vacuum fine – needle aspiration biopsy during the study were 95.6% and 92.5%, respectively. The data obtained indicate the effectiveness of the method.