TỶ LỆ UNG THƯ TUYẾN GIÁP QUA CHỌC HÚT TẾ BÀO KIM NHỎ Ở BỆNH NHÂN CÓ NHÂN GIÁP TỪ TIRADS 4 TRỞ LÊN CÓ YẾU TỐ NGUY CƠ CAO

Abstract

Objective: To determine the thyroid cancer prevalence through fine-needle aspiration (FNA) and to identify characteristics of high-risk patients with thyroid nodules classified as TIRADS 4 or higher. Study Subjects and Methods: A cross-sectional descriptive study was conducted on 200 patients aged 18 years and older with thyroid nodules classified as TIRADS 4, 5 according to the ACR TIRADS 2017 criteria. All patients were indicated for FNA and received examination and treatment at the National Hospital of Endocrinology. Results: The study found a high rate of thyroid cancer (93%) among patients with thyroid nodules. Fine-needle aspiration confirmed a 100% rate of papillary carcinoma in Bethesda category VI and a statistically significant rate of 96.43% in Bethesda category V (p<0.05). The majority of patients (71.5%) were asymptomatic. The most common symptoms were palpable nodules (9.5%), difficulty swallowing (8.5%), and visible mass in the anterior neck region (7%). Ultrasound findings revealed distinct characteristics between TIRADS 4 and TIRADS 5, such as echogenicity and microcalcifications. In TIRADS 4, most nodules lacked calcification (82.46%), whereas in TIRADS 5, the majority exhibited microcalcifications (67.13%). Nodule location varied between groups but showed no statistical significance (p>0.05). Conclusion: The rate of thyroid cancer through aspiration cytology of  TIRADS 4,5 nodules with risk factor was 93%. The Bethesda VI nodule group had 100% papillary carcinoma and the Bethesda V group had 96.43% cancer. The characteristics of thyroid nodules on ultrasound help guide diagnosis and fine needle aspiration cytology (FNA).