الفهرس | Only 14 pages are availabe for public view |
Abstract Objectives: to define the value of DNA ploidy in the management of solitary thyroid nodule. Patients and methods: 200 patients with clinically apparent thyroid nodules were included. 50 (25%) patients with true, solid and cold solitary thyroid nodule were subjected to FNAB and DNA flow cytometric measurements. Hemithyroidectomy was performed for patients showed benign criteria, suspicious criteria or unsatisfactory criteria by FNAB with diploid DNA. Total thyroidectomy was done for patients that showed malignancy by FNAB and or aneuploid DNA. All patients who were subjected to total thyroidectomy received radioactive iodine, Lthyroxin and external irradiation of the neck. Results: DNA aneuploidy was found to be more common in patients with thyroid carcinoma. Patients with benign solitary thyroid nodules who had diploid DNA were having higher proliferative indices. Also DNA flow cytometric measurements have decreased the percentage of false negative results of FNAB from 17.2% to 6.7%. Also have increased the predictability of malignancy by FNAB for suspicious and unsatisfactory smears. DNA aneuploidy was found to be more common in males, old age, extrathyroid extension, poor histological differentiation and metastasis. Also DNA aneuploidy was associated with recurrence and poor 2 years survival. Conclusion: DNA flow cytometry plays an important role in the diagnosis of thyroid nodules by combining the histogram and the results of FNAB which is of great value in the determination of the type of surgery required. Hemithyroidectomy is the procedure of choice that should be done for patients that showed benign criteria by FNAB with no abnormality detected by flow cytometric study. Total thyroidectomy is done for patients showing malignant criteria detected by either cytological examination or flow cytometric study. Patients with aneuploid differentiated thyroid tumors have poorer prognosis compared with patients with diploid tumors. |