A correlation study of thyroid nodule cytopathology and histopathology
P. Roldán, C. López-Tinoco, I. Mateo, L. Larrán, B. Ojeda, I. Gavilán, E. Vallejo, D. Martínez-Parra & M. Aguilar-Diosdado
Background: Fine-needle aspiration (FNA) biopsies are the cornerstone of preoperative evaluation of thyroid nodules, but FNA diagnostic performance has varied across different studies. We conducted a study to evaluate the effectiveness of ultrasound guided FNA in the thyroid nodule and to review the correlation between cytopathology and histopathology.
Methods: Prospective FNAs were collected from 511 patients who underwent a ultrasound guided FNA between 2008 and 2011. One hundred sixty-two patients underwent thyroidectomy. Cytology and surgical pathology results were matched in this group and sensitivity, specifity, positive predictive value and negative predictive value were calculated.
Results: The mean age was 54.7±13.4 years old (440 women and 71 men). The average size of nodules was 2.2±1.2 cm (2.75±1.45 in patients undergoing thyroidectomy). Multinodular goiter presented with dominant nodule 406 patients (79.5%) and 105 single nodule (20.5%). The FNA was inconclusive in 7.8% of cases. Benign cytology had 80.4% of patients, 9% indeterminate cytology and 1.8% malignant cytology. One hundred sixty two patients underwent thyroidectomy (58.8%, total thyroidectomy). From this population histopathology malignancy rates for prospective clinic FNAs were 10.7% for cytology indeterminate cases and 88.8% for cytology malignant cases. The FNAs had a sensitivity of 89%, specificity of 99%, positive predictive value of 89% and negative predictive value 99%.
Conclusions: Ultrasound-guided FNA provides important information for the diagnosis and the preoperative evaluation of thyroid nodules. The low rate of false-positive and false-negative results suggests that it might be enough for surgical planning for thyroid nodule.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.