Nodulo de tiroide : punção com agulha fina

Detalhes bibliográficos
Autor(a) principal: Canalli, Maria Heloisa Busi da Silva
Data de Publicação: 1998
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFSC
Texto Completo: http://repositorio.ufsc.br/xmlui/handle/123456789/77356
Resumo: Dissertação (Mestrado) - Universidade Federal de Santa Catarina, Centro de Ciencias da Saude
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spelling Nodulo de tiroide : punção com agulha finaTireoidePunçãoTesesTireoideCitopatologiaTesesTireoideHistopatologiaTesesDissertação (Mestrado) - Universidade Federal de Santa Catarina, Centro de Ciencias da SaudeEstudo do método de punção com agulha fina na avaliação de nódulo de tiróide em 379 pacientes. Comparação entre o diagnóstico clínico, cito e histopatológico foi realizada em 95 nódulos, após a 1a punção. Seguimento clínico e repetidas punções foram efetuados em 163 pacientes, sendo 28 operados. O rnétodo de punção com agulha fna empregado mostrou-se altamente acurado na análise de nódulos tiróideos, devendo ser repetido apenas em casos selecionados no decorrer do acompanhamento clínico. Abstract : The purpose of the study was to evaluate the use of fine-needle puncture or aspiration cytopathology (FNPc) in non-toxic, solitary or dominant thyroid nodule investigation in our environment. The values of cytophatological and clinical diagnoses were evaluated in cases with histopathological study after the first FNPc (FNP1c). Repeated FNPc were carried out in the follow-up routine, except for cases of hot nodules, inadequate FNP1c, and nodules no longer palpable. A single operator carried out all punctures, by palpation, and clinical evaluations. Cytophatological and histopathological results were performed by a same pathologist who had no previous knowledge of the cases. Clinical data were analyzed by chi-square tests and Student's t - test and logistic linear regression. Several stepwise logistic linear regression were performed, with and without cytopathological results, and diagnostic comparisons between the FNPlc, clinical data and clinical data + FNP1c were performed, including cases with FNP1c indeterminate as malignant or excluded from the analysis. Repeated FNPc were compared. In current study, 379 patients performed an average of 4.6 punctures/nodule and 9.0 representative glass slides to FNPlc, obtaining 73.6% benign FNPlc, 13.7% indeterminate, 7.4% malignant and 5.3% unsatisfactory. Ninety five patients realized hystopathological study of the nodules after adequate FNPlc, being 67 and 28 of them benign and malign, respectively. By univariate analysis, male sex; constitucional symptoms; hard consistency, irregular surface, tissue fixation of the nodule; and cervical lymphadenopathy were the significant parameters to establish the maligancy of the thyroid nodule. By logistic linear regression analysis, only male sex and hard consistency were the clinical determinants of malignancy. The sensibility, specificity and accuracy of FNPlc (nodules indeterminate included as malignant nodules) of clinical and FNPlc + clinical were, respectively, 96.4%, 61.2%, and 71.6%; 85.7%, 79.1%, and 81.1%; 85.7%, 94%, and 91.6%. Excluding the indeterrninate cytopathological cases, the diagnostic values for FNPlc were, respectively, 95.8%, 97.6%, and 97%, being superior to those of clinical values and unaltered when combined to them. FNPlc was concordant with the histopathology in 93.7% of the cases. From 163 patients submitted to follow-up and repeated FNPc, at mean intervals of 12.4 montbs, 152 had benign FNPlc and 11 indeterminate. A concordance of 92.6% was observed from the total of repeated FNPc and in 95.4% of the previously benign ones. Alteration from indeterminate FNPlc to benign occurred in 5 cases. From the 28 patients operated after repeated FNPc, malignancy was confirmed in 1 case out of 2 with initial benign cytodiagnostic altered to malignant, and in 2 persistently indeterminate cases. The FNPc was a simple and safe method, and well accepted by our patients. The inclusion of clinical data irnproved diagnostic accuracy of FNPc, specifically when indeterminate nodules were considered; however, the finding of neoplasm in 90.9% of these nodules warn us to consider surgery. The FNPc was a diagnostic instmmental of great accuracy and must be utilized in the initial evaluation of patients with thyroid nodules and repeated in clinical follow-up only on selected cases.Ioshu, Sergio OssamuUniversidade Federal de Santa CatarinaCanalli, Maria Heloisa Busi da Silva2012-10-17T03:19:59Z2012-10-17T03:19:59Z19981998info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisxix, [196]f.| il., grafs., tabs.+anexosapplication/pdf148739http://repositorio.ufsc.br/xmlui/handle/123456789/77356porreponame:Repositório Institucional da UFSCinstname:Universidade Federal de Santa Catarina (UFSC)instacron:UFSCinfo:eu-repo/semantics/openAccess2016-01-08T23:01:09Zoai:repositorio.ufsc.br:123456789/77356Repositório InstitucionalPUBhttp://150.162.242.35/oai/requestopendoar:23732016-01-08T23:01:09Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)false
dc.title.none.fl_str_mv Nodulo de tiroide : punção com agulha fina
title Nodulo de tiroide : punção com agulha fina
spellingShingle Nodulo de tiroide : punção com agulha fina
Canalli, Maria Heloisa Busi da Silva
Tireoide
Punção
Teses
Tireoide
Citopatologia
Teses
Tireoide
Histopatologia
Teses
title_short Nodulo de tiroide : punção com agulha fina
title_full Nodulo de tiroide : punção com agulha fina
title_fullStr Nodulo de tiroide : punção com agulha fina
title_full_unstemmed Nodulo de tiroide : punção com agulha fina
title_sort Nodulo de tiroide : punção com agulha fina
author Canalli, Maria Heloisa Busi da Silva
author_facet Canalli, Maria Heloisa Busi da Silva
author_role author
dc.contributor.none.fl_str_mv Ioshu, Sergio Ossamu
Universidade Federal de Santa Catarina
dc.contributor.author.fl_str_mv Canalli, Maria Heloisa Busi da Silva
dc.subject.por.fl_str_mv Tireoide
Punção
Teses
Tireoide
Citopatologia
Teses
Tireoide
Histopatologia
Teses
topic Tireoide
Punção
Teses
Tireoide
Citopatologia
Teses
Tireoide
Histopatologia
Teses
description Dissertação (Mestrado) - Universidade Federal de Santa Catarina, Centro de Ciencias da Saude
publishDate 1998
dc.date.none.fl_str_mv 1998
1998
2012-10-17T03:19:59Z
2012-10-17T03:19:59Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv 148739
http://repositorio.ufsc.br/xmlui/handle/123456789/77356
identifier_str_mv 148739
url http://repositorio.ufsc.br/xmlui/handle/123456789/77356
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv xix, [196]f.| il., grafs., tabs.+anexos
application/pdf
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFSC
instname:Universidade Federal de Santa Catarina (UFSC)
instacron:UFSC
instname_str Universidade Federal de Santa Catarina (UFSC)
instacron_str UFSC
institution UFSC
reponame_str Repositório Institucional da UFSC
collection Repositório Institucional da UFSC
repository.name.fl_str_mv Repositório Institucional da UFSC - Universidade Federal de Santa Catarina (UFSC)
repository.mail.fl_str_mv
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