Effect of nodule size on the reliability of fine-needle aspiration biopsy in thyroid nodules

To investigate the reliability of fine-needle aspiration biopsy (FNAB) in thyroid nodules and benign/malignant discrimination, particularly in large nodules. Materials and methods: A retrospective analysis of 1466 nodules in 402 patients with thyroid nodules who underwent thyroid surgery was made. The pathologic results of the thyroid nodules from preoperative FNAB and postoperative surgical pathology results were compared. Results: FNAB was found to be in accordance with the postoperative pathologic results. A concordance between the FNAB and postoperative pathologic results, particularly in nodules less than 3 cm in size, was detected. However, a similar finding was not detected in nodules larger than 3 cm in size. The rates, calculated without taking into consideration the nodule dimensions, were found to be: sensitivity, 47.65%; specificity, 93.98%; false-negative, 52.35%; and false-positive 6.02% Conclusion: In our experience, the false-negative rate of FNAB in nodules larger than 3 cm was high. Therefore, we have concluded that in the event of malignant FNAB, this rate is significant; however, in the event of benign FNAB, it should not be trusted too much.

Effect of nodule size on the reliability of fine-needle aspiration biopsy in thyroid nodules

To investigate the reliability of fine-needle aspiration biopsy (FNAB) in thyroid nodules and benign/malignant discrimination, particularly in large nodules. Materials and methods: A retrospective analysis of 1466 nodules in 402 patients with thyroid nodules who underwent thyroid surgery was made. The pathologic results of the thyroid nodules from preoperative FNAB and postoperative surgical pathology results were compared. Results: FNAB was found to be in accordance with the postoperative pathologic results. A concordance between the FNAB and postoperative pathologic results, particularly in nodules less than 3 cm in size, was detected. However, a similar finding was not detected in nodules larger than 3 cm in size. The rates, calculated without taking into consideration the nodule dimensions, were found to be: sensitivity, 47.65%; specificity, 93.98%; false-negative, 52.35%; and false-positive 6.02% Conclusion: In our experience, the false-negative rate of FNAB in nodules larger than 3 cm was high. Therefore, we have concluded that in the event of malignant FNAB, this rate is significant; however, in the event of benign FNAB, it should not be trusted too much.

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  • Dirican A. Evaluation of the diagnostic test’s performance and their comparisons. Cerrahpaşa Tıp Dergisi 2001; 32: 25–30 (in Turkish with English abstract).
  • Erdoğan G. Tiroid glandının neoplastik hastalıkları. Türkiye Klinikleri Tıp Bilimleri Dergisi 1990; 10: 427–442 (in Turkish).
  • Alfonso A, Chiristoudias G, Amarrudin Q. Tracheal or esophageal compression due to benign thyroid disease. Am J Surg 1981; 142: 350–354.
  • Wang C, Cropo LM. The epidemiology of the thyroid disease and implications for screening. Endocrinol Metab Clin North Am 1997; 26: 189–218. 6. Kabalak T. Tiroid. In: Kabalak T, editor. Endokrinoloji El Kitabı. İzmir, Turkey: Güven ve Nobel Tıp Kitabevleri; 2001. pp. 356 –359 (in Turkish).
  • Tambouret R, Szyfelbein WM, Pitman M. Ultrasound-guided fine needle aspiration biopsy of the thyroid. Cancer Cytopathol 1999; 87: 299–305. 8. Welker MJ, Orlov D. Ohio State University College of Medicine and Public Health. Thyroid cancer treatment. Ohio Am Fam Physician 2003; 67: 559–574.
  • Castro MR, Gharib H. Thyroid nodules and cancer. When to wait and watch, when to refer. Postgrad Med 2000; 107: 113– 116.
  • Koike E,  Noguchi S,  Yamashita H,  Murakami T,  Ohshima A, Kawamoto H, Yamashita H. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg 2001; 136: 334–337.
  • Frates MC,  Benson CB,  Charboneau JW,  Cibas ES,  Clark OH, Coleman BG, Cronan JJ, Doubilet PM, Evans DB, Goellner JR et al. Society of Radiologists in Ultrasound: Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237: 794–800.
  • Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr. Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 2003; 22: 1083–1090.
  • Iannuccilli JD, Cronan JJ, Monchik JM. Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J Ultrasound Med 2004; 23: 1455–1464.
  • Kaynaroğlu V. Tiroid ve paratiroid, tiroid nodüllerine genel yaklaşım. In: Sayek İ, editor. Temel Cerrahi. 2nd ed. Ankara, Turkey: Güneş Kitabevi; 1996. pp. 176–192 (in Turkish).
  • Mazafferi EL. Management of a solitary thyroid nodule. N Engl J Med 1993; 328: 553–556.
  • Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: Ann Intern Med 1993; 118: 282–289.
  • Papini E,  Guglielmi R,  Bianchini A,  Crescenzi A,  Taccogna S, Nardi F, Panunzi C, Rinaldi R, Toscano V, Pacella CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color Doppler features. J Clin Endocrinol Metab 2002; 87: 1941–1946.
  • Kuma K, Matsuzuka F, Yokozawa T, Miyauchi A, Sugawara M. Fate of untreated benign thyroid nodules: results of long-term follow-up. World J Surg 1994; 18: 495–498.
  • Burguera B, Gharib H. Thyroid incidentalomas. Prevalence, diagnosis, significance, and management. Endocrinol Metab Clin North Am 2000; 29: 187–203.
  • Alexander EK,  Hurwitz S,  Heering JP,  Benson CB,  Frates MC, Doubilet PM, Cibas ES, Larsen PR, Marqusee E. Natural history of benign solid and cystic thyroid nodules. Ann Intern Med 2003; 138: 315–318.
  • Schlinkert RT, van Heerden JA, Goellner JR, Gharib H, Smith SL,  Rosales RF,  Weaver AL. Factors that predict malignant thyroid lesions when fine-needle aspiration is “suspicious for follicular neoplasm”. Mayo Clin Proc 1997; 72: 913–916.
  • Meko JB, Norton JA. Large cystic/solid thyroid nodules: a potential false-negative fine-needle aspiration. Surgery 1995; 118: 996–1004.
  • Carling T, Udelsman R. Follicular neoplasms of the thyroid: what to recommend. Thyroid 2005; 15: 583–587.
  • Bahar G,  Braslavsky D,  Shpitzer T,  Feinmesser R,  Avidan S, Popovtzer A, Karl S. The cytological and clinical value of the thyroid “follicular lesion.” Am J Otolaryngol 2003; 24: 217–220.
  • Yang GCH, Goldberg JD, Ye PX. Risk of malignancy in follicular neoplasms without nuclear atypia: statistical analysis of 397 thyroidectomies. Endocr Pract 2003; 9: 510–516.
  • Sclabas GM, Staerkel GA, Shapiro SE, Fornage BD, Sherman SI,  Vassillopoulou-Sellin R,  Lee JE,  Evans DB. Fine-needle aspiration of the thyroid and correlation with histopathology in a contemporary series of 240 patients. Am J Surg 2003; 186: 702–710.
  • Chen H,  Nicol TL,  Zeiger MA,  Dooley WC,  Ladenson PW,  Cooper DS,  Ringel M,  Parkerson S,  Allo M,  Udelsman R. Hurthle cell neoplasms of the thyroid: are there factors predictive of malignancy? Ann Surg 1998; 227: 542–546.
  • Ravetto C, Colombo L, Dottorini ME. Usefulness of fine- needle aspiration in the diagnosis of thyroid carcinoma: a retrospective study in 37,895 patients. Cancer 2000; 90: 325– 329.
  • Mandell DL, Genden EM, Mechanick JI, Bergman DA, Biller HF, Urken ML. Diagnostic accuracy of fine needle aspiration and frozen section in nodular thyroid disease. Otolarygol Head Neck Surg 2001; 124: 531–536.
  • Sankhla DK, Hussein SS, Bererhi H, El Shafine O, Woodhouse NJ, Nirmala V. Are scintigraphy and ultrasonography necessary before fine-needle aspiration cytology for thyroid nodules? SQU Medical Sciences 2001; 1: 29–33.
  • McCoy KL, Jabbour N, Ogilvie JB, Ohori NP, Carty SE, Yim JH. The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size. Surgery 2007; 142: 837–844.
  • Dent LT, Kukorova JS, McCombs PR, Leibrandt TJ. Surgical tips solitary thyroid nodule. J Am Surg 1989; 12: 367 –384.
  • Bugis SP,  Young JE,  Archibald SD,  Chen VS. Diagnostic accuracy of fine-needle aspiration biopsy versus frozen section in solitary thyroid nodules. Surg. Clin North Am 1986; 152: 411–416.
  • Burrow GN. Aspiration needle biopsy of the thyroid. Ann Intern Med 1981; 95: 536–537.
  • Grant CS, Hay ID, Gough IR. Long-term follow-up of patients with thyroid nodules fine needle aspiration cytologic diagnoses. Surgery 1989; 106: 980–986.
  • Greer AM. The thyroid gland. J Am Surg 1990; 14: 147–168.
  • Thompson WN. Current diagnostic techniques for single thyroid nodule. Ann Intern Med 1983; 40: 255–259.
  • Nishiyama H, Sodd VJ, Berke RA, Saenger EL. Evaluation of clinical value of I-123 and I-131 thyroid disease. J Nucl Med 1974; 15: 261–267.
  • Livolsi VA. Developmental biology and anatomy of the thyroid, including the aberrant thyroid. In: Savetsky L, editor. Surgical Pathology of the Thyroid. Philadelphia, PA, USA: W.B. Saunders, 1990. pp. 123–145.
  • Le Douarin N, Le Lievre C. Embryologie experimentale: Demonstration de l’origine Neurale des cellules a calcitonine du corps ultimobranchial chez l’embryon de poulet. Academie des Sciences 1970; 270: 2857–2867 (in French).
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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