Diagnóstico de los nódulos de tiroides mediante estudio citológico por punción y aspiración con aguja fina

introduction: despite advances in used diagnostic tools, the identification of malignant thyroid nodules is still a challenge for pathologists, endocrinologists and surgeons. methods: an observational, descriptive and prospective study was carried out in 204 patients with nodular thyroid disease, treated at outpatient department in "saturnino lora" provincial teaching hospital of santiago de cuba (2007-2011), in whom cytology by fine-needle aspiration biopsy was performed. objective: to determine the diagnostic effectiveness of the cytology with fine-needle aspiration biopsy by comparing it with the result of final histological examination, as well as its economic impact. results: the report of the cytology by fine-needle aspiration biopsy was negative for malignancy in 111 patients (54.5 %) and positive in 23 (11.3 %); false positive in 4 (2.0 %), false negative in 20 (9.8 %) and without diagnosis in 40 (19.6 %). indicators of effectiveness identified were sensitivity (53.5 %), specificity (96.5 %), diagnostic accuracy (65.7 %), and positive and negative predictive values (85.2 and 84.7 %, respectively). there were 1.5% of complications and the average cost of the cytology was 50 times lower than that of thyroid surgery. conclusions: although this method is simple to perform, practically safe and inexpensive, the presence of the cytopathologist during its application is essential to guarantee the appropriate indicators of effectiveness.