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Diagnosis

Official Journal of the Society to Improve Diagnosis in Medicine (SIDM)

Editor-in-Chief: Graber, Mark L. / Plebani, Mario

Ed. by Argy, Nicolas / Epner, Paul L. / Lippi, Giuseppe / Singhal, Geeta / McDonald, Kathryn / Singh, Hardeep / Newman-Toker, David

Editorial Board: Basso , Daniela / Crock, Carmel / Croskerry, Pat / Dhaliwal, Gurpreet / Ely, John / Giannitsis, Evangelos / Katus, Hugo A. / Laposata, Michael / Lyratzopoulos, Yoryos / Maude, Jason / Sittig, Dean F. / Sonntag, Oswald / Zwaan, Laura


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2194-802X
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Diagnostic accuracy of fine needle aspiration cytology of thyroid nodules

Taskin Erkinuresin
  • Department of Pathology, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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/ Hakan Demirci
  • Corresponding author
  • Department of Family Medicine, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Yildirim, 16310 Bursa, Turkey
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-08-14 | DOI: https://doi.org/10.1515/dx-2019-0039

Abstract

Background

Routine application of fine needle aspiration cytology (FNAC) has decreased unnecessary referral of thyroid nodules for surgical treatment and has also increased the cancer rates found in surgery materials. Success of thyroid FNAC depends on skilled aspiration, skilled cytological interpretation and rational analysis of cytological and clinical data. The aim of this study was to determine the diagnostic accuracy rates of thyroid FNAC results obtained in our institution.

Methods

The data from FNAC and thyroidectomy reports of patients presenting with goiter and who had been evaluated from 1st January 2014 to 1st March 2018 were used. There were 149 patients in total who had undergone thyroidectomy following FNAC. The Bethesda System for Reporting Thyroid Cytology was used in all cytological diagnoses.

Results

The sensitivity of thyroid FNAC for malignant cases was 57.89%, specificity was 88.10%, false-positive rate was 11.90%, false-negative rate was 42.11%, positive predictive value was 52.38%, negative predictive value was 90.24% and accuracy rate was 82.52%. “Focus number” variable was detected as the factor that affected the accurate prediction of FNAC and thyroidectomy results by the pathologist.

Conclusions

This study showed that there was a moderate conformity between thyroid FNAC and thyroidectomy cyto-histopathological diagnosis in malignant cases. As two or more nodules have a negative effect on the physician’s diagnosis of malignant nodules, we think that a more sensitive approach is needed in the determination of these cases. Sampling defects may affect this non-matching.

Keywords: fine needle aspiration cytology; focus number; malignancy; predictivity; thyroid nodules

References

  • 1.

    Singh A, Pant S, Jain R, Kumar S. A prospective study on assessing the reliability of fine needle aspiration cytology in outcomes of thyroid lesions. Int Arch Bio Med Clin Res 2017;3:33–5.Google Scholar

  • 2.

    Amrikachi M, Ramzy I, Rubenfeld S, Wheeler TM. Accuracy of fine-needle aspiration of thyroid a review of 6226 cases and correlation with surgical or clinical outcome. Arch Pathol Lab Med 2001;125:484–88.Google Scholar

  • 3.

    Bouvet M, Feldman JF, Gill GN, Dillmann WH, Nahum AM, Russack V, et al. Surgical management of the thyroid nodule: patient selection based on the results of fine-needle aspiration cytology. Laryngoscope 1992;102:1353–6.PubMedCrossrefGoogle Scholar

  • 4.

    Iqbal J, Abdul Aziz OB, Ahmad N, Tariq M, Anwar Z. Diagnostic accuracy of fine needle aspiration cytology in the diagnosis of malignant solitary thyroid nodule. Pak Armed Forces Med J 2016;66:475–78.Google Scholar

  • 5.

    Srirangaprasad K, Nagaraj TM, Madav D, Mahajan R, Kumar P, George GK, et al. A study of correlation of preoperative fine needle aspiration cytology with histopathological examination in goitre. J Evol Med Dent Sci 2015;4:15414–7.CrossrefGoogle Scholar

  • 6.

    Sunder KS, Khan MI. Role of fine needle aspiration cytology in diagnosis of thyroid lesions. J Cont Med A Dent 2017;5:30–4.Google Scholar

  • 7.

    Cai XJ, Valiyaparambath N, Nixon P, Waghorn A, Giles T, Helliwell T. Ultrasound-guided fine needle aspiration cytology in the diagnosis and management of thyroid nodules. Cytopathology 2006;17:251–6.CrossrefPubMedGoogle Scholar

  • 8.

    Landis RL, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74.CrossrefPubMedGoogle Scholar

  • 9.

    Bibbo M. Comprehensive cytopathology. 2nd ed. Philadelphia, PA: W.B. Saunders Company, 1997. p 673.Google Scholar

  • 10.

    Team RC. A language and environment for statistical computing. R Foundation for Statistical Computing, 2013.Google Scholar

  • 11.

    Mittal A, Ahmad F, Dutta S, Nizammudin S, Awasthi S, Kumar A, et al. Use and accuracy of fine needle aspiration cytology in thyroid lesion: our experience in a tertiary teaching hospital in North India. Int J Sci Res 2015;3:95–100.Google Scholar

  • 12.

    Baloch ZW, Sack MJ, Yu GH, Livolsi VA, Gupta PK. Fine-needle aspiration of thyroid: an institutional experience. Thyroid 1998;8:565–9.PubMedCrossrefGoogle Scholar

  • 13.

    Ahmadinejad M, Aliepour A, Anbari K, Kaviani M, Ganjizadeh H, Nadri S, et al. Fine-needle aspiration, touch imprint, and crush preparation cytology for diagnosing thyroid malignancies in thyroid nodules. Indian J Surg 2015;77:480–3.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 14.

    Klemi PJ, Joensuu H, Nylama E. Fine needle aspiration biopsy in the diagnosis of thyroid nodules. Acta Cytol 1991;35:434–8.Google Scholar

  • 15.

    Tabaqchali MA, Hanson JM, Johnson SJ, Wadehra V, Proud G. Thyroid aspiration of cytology in New Castle; a six year cytology histology correlation study. Ann R Coll Surg Engl 2000;82:149–55.Google Scholar

  • 16.

    Kamal M, Dilip GA, Hemant RK. Comparative study of fine needle aspiration and fine needle capillary sampling of thyroids lesions. Acta Cytol 2002;46:30–4.CrossrefGoogle Scholar

  • 17.

    Jo VY, Stelow EB, Dustin SM, Hanley KZ. Malignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol 2010;134:450–6.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 18.

    Cusick EL, MacIntosh CA, Krukowski ZH, Williams VM, Ewen SW, Matheson NA. Management of isolated thyroid swellings: a prospective six year study of fine needle aspiration cytology in diagnosis. Br Med J 1990;301:318–21.CrossrefGoogle Scholar

  • 19.

    Silverman JF, West RL, Larkin EW, Park HK, Finley JL, Swanson MS, et al. The role of fine needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm. Cancer 1986;57:1164–70.CrossrefPubMedGoogle Scholar

  • 20.

    Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. J Endocrinol Investig 2010;33:51–6.Google Scholar

  • 21.

    Kuru B, Gulcelik NE, Gulcelik MA, Dincer H. The false-negative rate of fine-needle aspiration cytology for diagnosing thyroid carcinoma in thyroid nodules. Langenbecks Arch Surg 2010;395:127–32.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 22.

    Sadler TW. Thyroid gland. In: Langman’s medical embryology. 9th ed. Baltimore: Williams and Wilkins, 2004. p. 384–5.Google Scholar

  • 23.

    Johnstone JM, Wilson JA, Rintoul RF. The Thyroid gland and parathyroid glands. In: Neck, mastoid and Salivary glands. 8th ed. Edinburgh: Churchill Livingstone, 1995. p. 308–13.Google Scholar

  • 24.

    Sung JY, Na DG, Kim KS, Yoo H, Lee H, Kim JH, et al. Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. Eur Radiol 2012; 22:1564–72.CrossrefWeb of ScienceGoogle Scholar

  • 25.

    Schueller-Weidekamm C, Schueller G, Kaserer K, Scheuba C, Ringl H, Weber M, et al. Diagnostic value of sonography, ultrasound-guided fine-needle aspiration cytology, and diffusion-weighted MRI in the characterization of cold thyroid nodules. Eur J Radiol 2010;73:538–44.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 26.

    Ramacciotti CE, Pretorius HT, Chu EW, Barsky SH, Brennan MF, Robbins J. Diagnostic accuracy and use of aspiration biopsy in the management of thyroid nodules. Arch Intern Med 1984;144:1169–73.PubMedCrossrefGoogle Scholar

About the article

Corresponding author: Hakan Demirci, MD, Associate Professor, Department of Family Medicine, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Yildirim, 16310Bursa, Turkey, Phone: +905368963330


Received: 2019-05-27

Accepted: 2019-07-23

Published Online: 2019-08-14


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Diagnosis, 20190039, ISSN (Online) 2194-802X, ISSN (Print) 2194-8011, DOI: https://doi.org/10.1515/dx-2019-0039.

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