The combined use of thyroid ultrasonography with fine-needle aspiration cytology (FNAC) is an effective and economical tool for the diagnosis of thyroid nodules. Objective: To realize the contribution of thyroid ultrasound with FNAC including decreased thyroid cancer tumor size underwent surgical treatment, increasing ratio of papillary thyroid microcarcinoma.
Methods: Retrospectively review the data during the period between 1986 and 2007, a total of 38,848 patients underwent thyroid ultrasonography with FNAC in the Chang Gung Medical Center, Linkou, Taiwan. At the end of 2007, approximately 6,754 patients including 5,552 women (mean age 43.39 ± 14.03 years) and 1,202 men (mean age 46.59 ± 15.23 years) developed thyroid nodules (17.39%) underwent surgery.
Results: The percentage of patients who underwent surgical treatment decreased from 23.8% to 11.5%. Of the 6,754 operative cases, lesions in the case of 1,549 patients (22.93%) were histologically proved to be thyroid cancer. The percentage of thyroid cancers in surgically treated cases increased from 18.52% to 27.51%. Among the thyroid cancer patients, follicular thyroid cancers were detected in 157 patients (10.14%). The incidence of follicular thyroid cancer among all the thyroid cancer patients decreased from 15.79% to 7.30%. The mean tumor size of thyroid cancer decreased from 3.60±2.38 cm to 2.37±1.69 cm, and the percentage of papillary thyroid microcarcinomas in thyroid cancer increased from 8.06% to 22.94%.
Conclusions: This study illustrated that the application of thyroid ultrasound with FNAC could decrease number of patients who underwent unnecessary surgery by facilitating the early detection of thyroid cancers.