Timing of the repeat thyroid fine-needle aspiration biopsy: does early repeat biopsy change the rate of nondiagnostic or atypia of undetermined significance cytology result?

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2024-12-01 Epub Date: 2024-07-10 DOI:10.1007/s12020-024-03953-7

Fatma Dilek Dellal Kahramanca, Muhammet Sacikara, Aydan Kilicarslan, Berna Ogmen, Cevdet Aydin, Oya Topaloglu, Reyhan Ersoy, Bekir Cakir

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Abstract

Purpose: To determine whether early repeat fine needle aspiration biopsy (FNA) has an effect on adequate or atypia of undetermined significance (AUS) cytology rates in thyroid nodules with inadequate or AUS result in the first FNA.

Methods: Nodules of patients who underwent repeat biopsy due to insufficient or AUS cytology between 2019-2022 were included. Data of the patients and ultrasonographic, cytological and histopathological results of the nodules were recorded. Additionally, the time between the two biopsies was noted. The first was called "initial" and the second was called "rebiopsy". Five different paired groups were formed according to the time between two consecutive biopsies; before and after 1 month, 45 days, 2 months, 3 months, and 6 months. The groups were compared in terms of adequate and AUS cytological results.

Results: We evaluated 1129 patients with 2187 nodules undergoing FNAB. After excluding nodules with one FNA result and/or missing data, 966 nodules of 628 patients who underwent FNA at least twice were included. Initial cytology was nondiagnostic (ND) in 665 (30.4%) and AUS in 301 (13.8%) nodules. The mean age of the patients was 52.0 ± 11.9 years, and the female sex ratio was 78.8% (n = 495). There were no differences in adequate or AUS rebiopsy results according to the different time interval groups (p > 0.05 for all). AUS result was statistically insignificantly more frequent in nodules with initially AUS nodules when rebiopsy was performed before 1 month in comparison to after 1 month (53.8%, 27.1%; p = 0.054). Accuracy of rebiopsy was also similar in the time intervals groups (p > 0.05 for all).

Conclusion: In patients with inadequate or AUS initial biopsy, the rate of adequate or AUS cytology results at rebiopsy did not vary with the timing of repeat biopsy indicating that there may be no need to wait 1 month for a repeat biopsy. In patients with suspicious nodules, biopsy might be repeated before 1 month.

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重复甲状腺细针穿刺活检的时机：早期重复活检是否会改变非诊断性或意义不明的不典型细胞学结果的发生率？

目的：旨在确定早期重复细针穿刺活检（FNA）是否会影响首次FNA结果不足或AUS的甲状腺结节细胞学检查的充分率或意义未定的不典型性（AUS）率：方法：纳入2019-2022年间因细胞学检查结果不足或AUS而接受重复活检的甲状腺结节患者。记录患者数据以及结节的超声、细胞学和组织病理学结果。此外，还记录了两次活检之间的时间间隔。第一次活检称为 "初次活检"，第二次活检称为 "再次活检"。根据两次连续活检之间的时间间隔形成了五个不同的配对组：1 个月前后、45 天、2 个月、3 个月和 6 个月。各组在充分性和 AUS 细胞学结果方面进行了比较：我们对 1129 名患者的 2187 个结节进行了 FNAB 评估。在排除了只有一次 FNA 结果和/或数据缺失的结节后，我们纳入了至少接受过两次 FNA 的 628 名患者的 966 个结节。665个结节（30.4%）的初始细胞学结果为非诊断性（ND），301个结节（13.8%）的初始细胞学结果为AUS。患者的平均年龄为（52.0 ± 11.9）岁，女性比例为 78.8%（495 人）。不同时间间隔组的足量或 AUS 重新活检结果无差异（均 p > 0.05）。与 1 个月后相比，在 1 个月前进行重新活检时，最初为 AUS 的结节中出现 AUS 结果的频率更高（53.8%，27.1%；P = 0.054），这在统计学上并不显著。各时间间隔组的重新活检准确率也相似（P均>0.05）：结论：对于初次活检结果不充分或AUS的患者，再次活检时细胞学结果充分或AUS的比率并不随再次活检的时间而变化，这表明可能没有必要等待1个月再进行再次活检。对于有可疑结节的患者，可在 1 个月前再次进行活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.