Informativeness of the Preoperative Examinations in Patients with Small Focal Lesions of the Thyroid Gland

Introduction. Doctors of various specialties - endocrinologists, endocrine surgeons, oncologists - pay much attention to the choice of tactics of treatment of small focal forms of thyroid gland. However, despite the tangible progress, the transition to a molecular or genetic level of the diagnosis is a reality of the next decades, but today we should not underestimate the need to improve the existing diagnostic methods. Aim. To find out the informativeness of preoperative examinations and causes of diagnostic errors in patients with thyroid nodes ≤ 1.0 cm. Materials and methods. A retrospective analysis of information from out-patient cards, history of diseases and protocols of operations of randomly selected 1 266 patients operated on thyroid lesions (thyroid nodules up to 1.0 cm) in the surgical department of the Kyiv Regional Clinical Hospital N 1 in 2009-2014 was conducted. The results of the pathomorphological, cytological and ultrasound findings were compared, the sensitivity and specificity of the ultrasound examination and the fine needle aspiration biopsy using the ultasound in a diagnosis of the subsantimetric thyroid nodes, including microcarcinoma were evaluated. The frequency of the erroneous results of the histological and ultrasound diagnostics of the thyroid microcarcinoma were determined. Results. Sensitivity and specificity of commonly used diagnostic methods of thyroid ultrasonography and thyroid gland with the following cytological examination are 73.9, 79.5 and 71.9 and 83.9% respectively, and therefore can not be applied separately for the verification of small thyroid glands. The reason for the diagnostic errors, in our opinion, in each case is a separate, rather than a comprehensive analysis of the results of the survey. Obtaining the informative material from the patients with the nodes less than 1 cm in diameter in the thyroid gland, depends on the concerted actions of the doctor of ultrasound and the surgeon, as well as the correct choice of nodes, which need to point out first. Conclusions. Today, for the early diagnosis of thyroid cancer in sub-arterial nodes, a comprehensive evaluation of the results of ultrasound scans and an aiming thin-blooded aspiration biopsy with the subsequent cytological study of the material are most optimal.