A Clinical Study on Distribution of Malignant Lesions on FNAC in a Study Population Attending a Teaching Hospital in North India
Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 12
Abstract
Aim: the present study is undertaken to evaluate the distribution of malignant lesions on FNAC in Nothern Indian population. Introduction: Clinical examination, although very accurate in most cases of thyroid lesion, is inadequate in some areas especially, in staging of thyroid malignancies and in detecting the multi-nodularity of the gland. Material And Methods: The study was conducted in a teaching hospital for a period of 1 year. It was a prospective hospital based Study. In each case, a brief clinical history and examination was carried out. Patient were explained about whole of the procedure & the consent for the procedure was taken in all patients. FNAC of thyroid gland was done both free guided and ultrasonic- guided and the results were correlated statistically Observation: Out of total 139 patients, 87 patients were benign; 19 were male and 68 were female. The malignant lesions were 39; 8 were male and 31 were female. The most common neoplastic lesion by ultrasound guided FNAC was Papillary carcinoma accounting for 32, 3 cases of Medullary carcinoma, 1 Anaplastic carcinoma, 2 cases of Hurthle's carcinoma and 1 Lymphoma. In Free hand FNAC, 36 out of 139 patients were cytologically diagnosed as neoplastic cases were diagnosed. Two cases of papillary carcinoma and one case of medullary carcinoma were not picked up in Free hand FNAC and was diagnosed in USG Guided FNAC, which yielded representative material for cytological study. Comparison of neoplastic lesions results both by USG guided FNAC and Free Hand FNAC in 38 patients shows difference of 2 cases in Papillary carcinoma,1 case in medullary carcinoma ,while as Anaplastic carcinoma, Hurthle’s cell carcinoma and Lymphoma were each one by both the techniques. Number of unsatisfactory smears were 4 and 1 in free and USG Guided FNAC respectively. We categorised the study sample as per Betheseda System. In USG-guided unsatisfactory were 4, benign were 87, Atypia of Undetermined Significance was none, Suscipicious for malignancy was none and malignant were 39.In Free-hand FNAC, unsatisfactory were 15,, benign were 81, stypia Of Undetermined Significance was none, suscipicious for malignancy was none and malignant were 36.In USG guided FNAC, Sensitivity was 96.96%, Specificity was 93.3%. Positive predictive value was 96.96%, Negative predictive value was 93.33% and Diagnostic accuracy was 95%.In Free Hand FNAC, Sensitivity was90.0%, Specificity was 80.0%. Positive predictive value was 90.0 %, Negative predictive value was 80% and Diagnostic accuracy was 86.66%. Conclusion: There was significant difference in the comparison of USG- guided FNAC and Conventional FNAC in Benign and Malignant lesions. The statistical significance of USG-guded FNAC as: Sensitivity 96.96%, Specificity 93.3%, Positive predictive value 96.96%,negative predictive vale 93.33%,diagnostic accuracy 95%.The statistical significance of USG-guded FNAC as: Sensitivity 90%, specificity 80%, positive predictive value 90%, negative predictive vale 80%, diagnostic accuracy 86.66%.
Authors and Affiliations
Dr. Irfan Khan
Keywords
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