Diagnostic accuracy of fine needle aspiration cytology in patients undergoing  thyroidectomy in Uganda: tertiary hospital experience.

Robert Masereka, Paul K. Okeny, Jane .O. Fualal, Dan Wamala
1. Department of Surgery, Makerere University College of Health Sciences (MakCHS), P.O Box 7062
Kampala – Uganda
2. Department of Surgery, Gulu Regional Referral and Teaching Hospital, P.O Box 160 Gulu – Uganda
3. Department of Surgery, Mulago National Referral Hospital
4. Department of Pathology, Mulago NationalReferral Hospital

Abstract
Background: Thyroid disease affects about 5% of the World’s population. Fine Needle Aspiration Cytology (FNAC) helps in  planning extent of surgery. In some studies, FNAC has been found to have a low accuracy for malignancy.

Objective: To estimate the sensitivity and specificity of FNAC in detecting malignancy for thyroid disease using histopathology  as the gold standard.

Methods:Patients who underwent clinical and laboratory evaluation and thyroidectomy at Mulago National Referral hospital  and the Pathology department of Makerere University College of Health Sciences were consecutively recruited over a four  months period. Analysis using STATA version 10 focused on sensitivity, specificity and accuracy of FNAC in detecting malignancy.

Results: In total, 99 patients were recruited, the F:M ratio was 15.5:1 and median age was 42 years (IQR 34-50). The median  duration of symptoms was 364 weeks (IQR 104-986). The proportion of patients with malignancy was 13.3% with papillary  thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The  sensitivity was 61.5% and specificity 89.5% .

Conclusion:This study revealed high specificity and low sensitivity of Fine Needle Aspiration Cytology (FNAC) at detecting  malignancy in thyroid nodules

Keywords: Diagnostic accuracy, fine needle aspiration, cytology, thyroidectomy, tertiary hospital