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THE IMPACT OF SYNOPTIC CYTOLOGY REPORTING ON THYROIDECTOMY RATE IN A SINGLE INSTITUITION
Author(s) -
Tsan C. J. L.,
Serpell J. W.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_1.x
Subject(s) - medicine , thyroidectomy , general surgery , cytology , thyroid , pathology
Background Fine needle aspiration cytology (FNAC) is integral to diagnosis and management of patients with thyroid nodules. We introduced synoptic cytology reporting for thyroid nodules in 2004. The aim of the study was to examine the impact of synoptic cytology reporting. Methods A comparative study of two 2‐year periods (1/8/2002–1/8/2004 and 2/8/2004–2/8/2006) prior and post introduction of synoptic reporting was conducted from a prospectively collected database of patients presented with thyroid nodules. All data were analysed using Microsoft excel and statistics calculated with likehood ratio and chi square tests. Results There were a total of 660 patients. Of these 376 were operated and 284 non‐operated. The female to male ratio was 1 : 7. Comparing the 2 periods, the overall FNAC sensitivities were 60% vs 79.1%, specificities were 83.7% vs 79.4%, accuracy 76% vs 79.3%, false positive 16.3% vs 20.6% and false negative of 40% vs 20.9%. The non diagnostic rates were 7.4% vs 3.15%. FNAC prompted surgery in 66.7% vs 100% in carcinoma and 56.4% vs 73.6% in adenoma. A benign FNAC prompted surgery in 15% VS 19.8% of cases. The total rate of surgery has decreased by 2.7%. Conclusions Synoptic cytology reporting has resulted in an overall improvement in all measures of the tests. The rate of surgery has decreased by 2.7%. Synoptic cytology reporting is therefore recommended for all endocrine surgical units.