Fine-needle aspiration cytology of thyroid nodules--how well are we doing?
OBJECTIVE
To review the accuracy of fine-needle aspiration cytology in diagnosing non-toxic thyroid nodules and determine what factors are predictive of malignancy in patients with indeterminate cytology results.


METHODS
Retrospective study.


METHODS
Regional hospital, Hong Kong.


METHODS
Patients with non-toxic thyroid nodules undergoing thyroidectomy from December 1999 to December 2003.


METHODS
Sensitivity, specificity, positive and negative predictive value of fine-needle aspiration cytology, predictive factors for malignancy in patients with indeterminate fine-needle aspiration cytology results.


RESULTS
The sensitivity, specificity, positive predictive value, and negative predictive value of fine-needle aspiration cytology were 54%, 100%, 100%, and 75% respectively. For the 92 patients with fine-needle aspiration cytology reported as 'indeterminate for malignancy', aspiration cytology subgroup (P=0.005) and age (P=0.001) were significant risk factors for diagnosing malignancy.


CONCLUSIONS
Fine-needle aspiration cytology has high positive predictive value for thyroid cancer, enabling us to 'rule-in' malignant lesions with confidence. Among those with indeterminate fine-needle aspiration cytology, atypical cell lesions and age greater than 40 years conferred increased risk of malignancy.
Cheung
Y S
YS
Department of Surgery, North District Hospital, Po Kin Road, Sheung Shui, Hong Kong.
Poon
C M
CM
Mak
S M
SM
Suen
Michael W M
MW
Leong
H T
HT
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000367:Age Factors; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy