title: Fine-Needle Thyroid Aspiration Biopsy: Clinical Experience at the Endocrinology Clinics of the University Hospital of Puerto Rico.
abstract: This study aimed to establish a profile of the ultrasound-guided thyroid fine-needle aspiration biopsies (FNABs) performed at the endocrinology clinics of the University Hospital of Puerto Rico.
  
  
  
  A retrospective study was conducted to assess all the thyroid FNABs performed from July 1, 2011, to December 31, 2013. Data on socio-demographic, FNAB cytology, surgery, and histopathology were collected from medical records. A chi-square test was used to assess associations between predictors and outcome. McNemar's test was used to compare FNAB cytology and histopathology results.
  
  
  
  A total of 240 FNABs were performed on 192 patients; 91.2% were female. The distribution of the cytological diagnoses was as follows: 181 (75.4%) were benign; 39 (16.3%) were non-diagnostic; 15 (6.3%) were indeterminate; and 5 (2.1%) were malignant. A malignant cytology was more likely in patients younger than 45 y/o than in their older counterparts (p = 0.01); a similar result was found for patients who smoked vs. those who did not (p = 0.02). Benign nodules were more likely to be larger than 1 cm than were those that were malignant (88.2% vs. 25%). Histopathology results were available for 38 nodules; there were no statistically significant differences between the cytology and histopathology results (p>0.05). The sensitivity and specificity for FNAB cytology were 75% and 100%, respectively. Of the nodules with an initial indeterminate cytology (47%), 71% demonstrated, ultimately, benign histopathology.
  
  
  
  In our study, most of the FNABs performed yielded a benign cytology. A high concordance was shown between cytology and histology. For those with indeterminate cytology, the majority of cases demonstrated benign histopathology. These data suggest the need to implement other approaches, such as the development and subsequent use of molecular markers, to improve our diagnostic and therapeutic strategies, this according to our population-based disease prevalence.
authors.affiliation: Internal Medicine Department, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
authors.forename: Milliette
authors.initials: M
authors.lastname: Alvarado-Santiago
authors.affiliation: Internal Medicine Department, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
authors.forename: Dalitza
authors.initials: D
authors.lastname: Alvarez-Valentin
authors.affiliation: Internal Medicine Department, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
authors.forename: Oscar
authors.initials: O
authors.lastname: Ruiz-Bermudez
authors.affiliation: Research Design and Biostatistics Core, Puerto Rico Clinical and Translational Research Consortium.
authors.forename: Lorena
authors.initials: L
authors.lastname: Gonzalez-Sepulveda
authors.affiliation: Internal Medicine Department, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
authors.forename: Myriam
authors.initials: M
authors.lastname: Allende-Vigo
authors.affiliation: Research Design and Biostatistics Core, Puerto Rico Clinical and Translational Research Consortium.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Santiago-Rodriguez
authors.affiliation: Research Design and Biostatistics Core, Puerto Rico Clinical and Translational Research Consortium.
authors.forename: Sona
authors.initials: S
authors.lastname: Rivas-Tumanyan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis*; D016606:Thyroid Nodule / Q000175:diagnosis*; D018084:Ultrasonography, Interventional / Q000379:methods; D055815:Young Adult
keywords: Cytology; Thyroid fine-needle aspiration biopsy; Thyroid nodules