| dc.description.abstract | Thyroid masses are common surgical presentations with a worldwide prevalence of 4–7% in
the general adult population. Africa, specifically Kenya is not excluded from these surgical
conditions. The vast majority of adult thyroid nodules are benign neoplasm’s, however, less
than 10% are malignant, which makes it important to screen the nodules in order to offer
appropriate surgery and avoid unnecessary surgery for benign nodules. It is preferred to
operate only on those patients with suspicion of malignancy, while strict patient follow-up is
necessary in dealing with benign cases. Fine needle aspiration cytology (FNAC) is known to
play a pivotal role in the screening and management of thyroid swellings. FNAC is done in
an increasing number of patients presenting with thyroid masses at the Moi Teaching and
Referral Hospital, however its findings are yet to be incorporated into the management and
planning of these masses. The aim of this study was to assess the diagnostic accuracy of
FNAC in evaluating thyroid nodules at the Moi Teaching and Referral Hospital in order to
establish a basis of whether or not to incorporate its findings in the management of these
masses pre-operatively. This was a retrospective study where FNAC and corresponding
histological evaluation findings of 118 patients aged 17-88 years who had a pre-operative
FNAC and subsequently a thyroid resection for definitive histological diagnosis between
January 2007 and December 2014 were randomly sampled and accessed from the archives of
MTRH and compared for concordance and discordance. Of the 118 FNAC, 17 (14.40%)
were inadequate to make a diagnosis, 14(11.86%) were suspicious for malignancy, and 78
(66.1%) were benign while 9 (7.62%) were malignant. The benign cases consisted
predominantly of colloid goiter (54.54%) whereas the malignant ones consisted
predominantly of papillary carcinomas (5.08%). The concordance, false positive and false
negative rates were 90.80%, 3.44% and 5.74% respectively. The accuracy, sensitivity,
specificity, positive predictive value and negative predictive values of FNAC were 90.80%,
54.54%, 96.05%, 66.66% and 94.58% respectively. There was a significant agreement
between the two tests (p= 0.34). FNAC of thyroid is accurate and has a low rate of falsenegatives
and false-positives diagnoses hence can be adopted and relied upon in evaluating
thyroid nodules pre-operatively. Use of FNAC reduces the rate of unnecessary surgeries, the
cost of health care and the risks associated with surgeries, resulting in better outcome of
patients care. | en_US |
