Concordance Clinique, Échographique et Anatomopathologique des Nodules Thyroïdiens à Yaoundé

RESUME Introduction. Malgre l’existence de classifications echographique (TIRADS) et cytopathologique (BETHESDA), l’on observe encore de nombreuses chirurgies inutiles pour nodules thyroidiens benins. Objectifs. Nous avons voulu determiner la concordance entre les donnees cliniques, echographiques et anatomo-pathologiques des nodules thyroidiens dans notre milieu. Materiel et Methode. Nous avons mene une etude transversale analytique dans 3 hopitaux universitaires de Yaounde sur une periode de 6 ans allant de 2015 a 2021. Notre echantillon etait constitue de patients porteurs de nodule(s) thyroidiens(s), disposant de donnees cliniques, echographiques, cytopathologiques et/ou histopathologiques de ce(s) nodule(s). Notre echantillonnage etait consecutif non exhaustif. Les variables etudiees etaient socio-demographiques, cliniques, echographiques et cytopathologiques. Resultats. Nous avons recrute 89 patients. Le sex ratio etait de 0,4. L’âge moyen etait de 45,8 ans. La categorie clinique a risque intermediaire de malignite etait la plus representee (68,5%). Il s’agissait le plus souvent de la categorie echographique a risque faible de malignite (40,4%), suivie de celle a risque eleve de malignite (31,5%). Le score Bethesda II etait le plus retrouve, soit 38%. La prevalence du cancer etait de 28,2%. Le type histologique le plus frequent etait le carcinome papillaire (65%). Les concordances clinico-echographique et clinico-cytopathologique etaient faibles. La concordance entre l’echographie et la cytopathologie est bonne (K= 0,52 ; IC : 0,46 a 0,65). Conclusion. Au vu de la bonne concordance echo-cytopathologique, des efforts doivent etre faits afin d’appliquer une demarche rigoureuse dans le respect de la standardisation de prise en charge des nodules thyroidiens classes a l’echographie.ABSTRACTIntroduction. Despite the existence of ultrasound (TIRADS) and cytopathological (BETHESDA) classifications, there are still many unnecessary surgeries for benign thyroid nodules. Goals. We wanted to determine the concordance between clinical, ultrasound and anatomo-pathological data in our environment. Method. We conducted a cross-sectional analytical study in 3 university hospitals in Yaounde over a period of 6 years from 2015 to 2020. Our sample consisted of patients with thyroid nodule (s), with data on the clinical examination, ultrasound and cytopathology and / or histopathology of this (s) nodule (s). Our sampling was non-exhaustive consecutive. The variables studied were socio-demographic, clinical, ultrasound and cytopathological. Results. We recruited 89 patients. The sex ratio was 0.4. The average age was 45.8 years. The clinical category at risk of intermediate malignancy was the most represented (68.5%). This was most often in the ultrasound category at low risk for malignancy (40.4%), followed by that at high risk for malignancy (31.5%). The Bethesda II score was the most common, at 38%. The prevalence of cancer was 28.2%. The most common histologic type was papillary carcinoma (65%). The concordances between clinic and ultrasound, clinic and cytopathology were low. The concordance between ultrasound and cytopathology is good (K = 0.52; CI: 0.46 to 0.65). Conclusion. In view of the good cytopathological echo agreement, efforts must be made to comply with a rigorous approach according to the standards of the management of thyroid nodules classified by ultrasound.