Factores asociados a histopatología final benigna en pacientes con biopsia por aspiración con aguja fina clasificados como Bethesda en IV –V-VI en Hospital de San José.
Mejía, María Gimena | 2017-11-30
Introduction: Nowadays, with the use of ultrasounds and fine needle aspirations, 20 to 50% of patients receive thyroidectomies. However, some of these are false positives who are unnecessarily intervened, with all the complications a thyroidectomy may bring.
Objective: Evaluate the factors associated to benign final histopathology in patients classified as Bethesda IV-V-VI through fine needle aspiration.
Methodology: Case and control studies. The cases will be patients surgically intervened through fine needle aspiration, initial IV, V, VI in the Hospital de San José with final benign final histopathology, and the controls will be patients with malignant final histopathology.
Fine needle aspiration cytology will be submitted to an interobserver study.
Results: 86 cases and 86 controls were included, The category Bethesda IV presented the highest number of false positives, 89%, p.0.000.
The logistic regression model concluded that being categorized as bethesda IV is associated with a higher risk of false positives.
The interobserver study was obtained in 28 out of 86 cases, and there was a substantial agreement 93,6%, p .000, Kappa 0.777 substantia. Moreover, it was found that in the second reading they were recategorized as benign 71% by pathologist 1 and 53,5% by pathologist 2.
Conclusion: It could be suggested that certain subcategories are determined in the category Bethesda IV which minimize the number of f surgeries
False positives in Bethesda IV are still a challenge, and molecular testing and second revisions become extremely important.
the ultrasonographic characteristics that marked importance for malignancy are microcalcifications and extension.