Şenoymak M C, Erbatur N H, Engin I, Yönem A
University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey.
Acta Endocrinol (Buchar). 2024 Jan-Mar;20(1):39-44. doi: 10.4183/aeb.2024.39. Epub 2024 Oct 3.
Fine-needle aspiration biopsy (FNAB) is the most accurate diagnostic method to assess the malignancy risk of thyroid nodules. However, non-diagnostic results may delay diagnosis, cause unnecessary interventions, and distress patients.
We aimed to determine whether a correlation exists between patients' situational anxiety, pain perception and non-diagnostic cytology results.
The prospective study included patients who underwent thyroid FNAB at the Endocrinology Clinic of Sultan Abdulhamid Training and Research Hospital between 11/2022 and 02/2023. The State-Trait Anxiety Inventory (STAI) questionnaire and visual analogue scale (VAS) assessed situational anxiety and pain in patients undergoing biopsy procedures. We evaluated whether the STAI-S and VAS score is related to non-diagnostic results.
Of the 119 patients included in the study, 98 were female, and 21 were male. 25 (21%) nodules were non-diagnostic. The patients' mean STAI-S score before the biopsy was 47.31±12.37, and the mean VAS score after the thyroid biopsy was 2.57±1.51. A statistically significant relation was found between the patient's STAI-S score and VAS score and the cytology result of non-diagnostic (p= 0.001 and p=0.008). In univariate logistic regression, high pre-procedural anxiety (OR:3.09, 95% CI:1.07-8.94, P =0.037) and VAS score (OR:1.57, 95% CI: 1.17-2.10, P =0.002) were associated with non-diagnostic cytology. In multivariate logistic regression analysis, VAS score (OR: 1.59, 95% CI: 1.07-2.34, p=0.019) was still an independent factor related to specimen adequacy.
Anxiety level and pain perception during FNAB may be considered risk factors for non-diagnostic cytology. Thus, reducing anxiety and pain may decrease the incidence of non-diagnostic outcomes.
细针穿刺活检（FNAB）是评估甲状腺结节恶性风险最准确的诊断方法。然而，非诊断性结果可能会延迟诊断、导致不必要的干预并使患者感到困扰。
我们旨在确定患者的情境焦虑、疼痛感知与非诊断性细胞学结果之间是否存在相关性。
这项前瞻性研究纳入了2022年11月至2023年2月期间在苏丹·阿卜杜勒哈米德培训与研究医院内分泌科门诊接受甲状腺FNAB的患者。采用状态-特质焦虑量表（STAI）问卷和视觉模拟量表（VAS）评估活检过程中患者的情境焦虑和疼痛情况。我们评估了STAI-S和VAS评分是否与非诊断性结果相关。
该研究纳入的119例患者中，98例为女性，21例为男性。25个（21%）结节为非诊断性。活检前患者的平均STAI-S评分为47.31±12.37，甲状腺活检后的平均VAS评分为2.57±1.51。患者的STAI-S评分和VAS评分与非诊断性细胞学结果之间存在统计学显著相关性（p = 0.001和p = 0.008）。在单因素逻辑回归中，术前高焦虑（OR：3.09，95%CI：1.07 - 8.94，P = 0.037）和VAS评分（OR：1.57，95%CI：1.17 - 2.10，P = 0.002）与非诊断性细胞学相关。在多因素逻辑回归分析中，VAS评分（OR：1.59，95%CI：1.07 - 2.34，p = 0.019）仍然是与标本充足性相关的独立因素。
FNAB过程中的焦虑水平和疼痛感知可能被视为非诊断性细胞学的危险因素。因此，减轻焦虑和疼痛可能会降低非诊断性结果的发生率。
