Accuracy and consistency of fine-needle aspiration biopsy in the diagnosis and management of solitary thyroid nodules.
BACKGROUND
Fine-needle aspiration biopsy has been well established as a diagnostic technique for selecting patients with thyroid nodules for surgical treatment, thereby reducing the number of unnecessary surgical procedures in cases of non-malignant tumors.


OBJECTIVE
To evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of FNAB in cases of a solitary thyroid nodule.


METHODS
The preoperative FNAB results in 170 patients who underwent thyroidectomy due to a solitary thyroid nodule were compared retrospectively with the final postoperative pathologic diagnoses.


RESULTS
In cases of a solitary thyroid nodule, FNAB had a sensitivity of 79%, specificity of 98.5%, accuracy of 87%, and positive and negative predictive values of 98.75% and 76.6% respectively. All cases of papillary carcinoma diagnosed by FNAB proved to be malignant on final histology, while 8 of 27 cases of follicular adenoma detected by preoperative FNAB were shown to be malignant on final evaluation of the surgical specimen.


CONCLUSIONS
FNAB cytology reduces the incidence of thyroidectomy since this method has excellent specificity and sensitivity and a low rate of false-negative results. It proved to be cost-effective and is recommended as the first tool in the diagnostic workup in patients with thyroid nodules.
Department of Otolaryngology, Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
Alexander
A
Kessler
Haim
H
Gavriel
Sergei
S
Zahav
Michael
M
Vaiman
Nathan
N
Shlamkovitch
Samuel
S
Segal
Ephraim
E
Eviatar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery