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Date Published: 31/12/2025
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DOI: https://doi.org/10.51298/vmj.v557i2.16717
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Vol. 557 No. 2 (2025)
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Các bài báo
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Phan, H. H., & Lâm, Ái Q. (2025). COMPARISON OF ULTRASOUND, CYTOLOGY, AND HISTOPATHOLOGY RESULTS IN THYROID NODULES POST-SURGERY AT CHO RAY HOSPITAL. Vietnam Medical Journal, 557(2). https://doi.org/10.51298/vmj.v557i2.16717

COMPARISON OF ULTRASOUND, CYTOLOGY, AND HISTOPATHOLOGY RESULTS IN THYROID NODULES POST-SURGERY AT CHO RAY HOSPITAL

Hữu Hên Phan, Ái Quỳnh Lâm

Main Article Content

Abstract

Background: Thyroid nodules are a common endocrine disorder, yet only 5-10% are malignant. The primary clinical challenge is to determine the malignancy risk of these nodules to select appropriate candidates for surgery. Ultrasound (US) and fine-needle aspiration (FNA) are two crucial diagnostic tools, but data simultaneously comparing both methods against the gold standard, histopathology, in post-operative patients remain limited. This study was conducted to compare the results of US, cytology, and histopathology to evaluate their diagnostic values. Objective: To determine the diagnostic value of US, cytology, and their combination for thyroid cancer in patients with thyroid nodules who underwent surgery at Cho Ray Hospital. Method: A retrospective, cross-sectional, analytical study was conducted on 248 patients with thyroid nodules who underwent surgery at Cho Ray Hospital from January 2024 to August 2024 and had complete US, cytology, and histopathology results. Result: The malignancy rate on histopathology was 74,2%, predominantly papillary thyroid carcinoma (71,8%). US features associated with malignancy included hypoechogenicity, microcalcifications, taller-than-wide shape, solid composition, and TIRADS 4-5 classification. The diagnostic value of US showed a sensitivity (Se) of 88,0%, specificity (Sp) of 68,8%, and accuracy (Acc) of 83,1%. Cytology (excluding indeterminate cases) demonstrated superior performance with Se 97,9%, Sp 97,0%, and Acc 97,7%. Combining US and cytology using the OR principle (excluding indeterminate cases) increased Se to 99,3% and Acc to 96,6%. Using the AND principle, Sp reached 97,0% and positive predictive value (PPV) was 99,2%. Conclusion: The study revealed a high rate of malignancy in the surgical cohort of thyroid nodules. Cytology has a higher diagnostic value than ultrasound. The combination of US and cytology significantly improves diagnostic accuracy, aiding clinicians in screening and surgical decision-making

Article Details

Keywords

Thyroid nodule, Ultrasound, Fine-needle aspiration, Histopathology, TIRADS, Bethesda

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