title: Comparison of fine-needle aspiration and fine-needle capillary sampling of thyroid nodules: a prospective study with emphasis on the influence of nodule size.
abstract: BACKGROUND
  The objective of this study was to compare the sampling efficiency of ultrasound-guided fine-needle aspiration (FNA) and fine-needle capillary (FNC) sampling in thyroid nodules, in which the authors specifically analyzed the influence of nodule size.
  
  
  METHODS
  This study included 280 thyroid nodules in 275 consecutive patients. The nodules were divided into 4 size subgroups: ≤5.0 mm, from 5.1 to 10.0 mm, from 10.1 to 20.0 mm, and >20.0 mm. Each nodule was sampled by both FNA and FNC. The final cytopathologic findings were reported. The smears were scored and then categorized as diagnostically inadequate, adequate, or superior on the basis of 4 parameters, which included background clot or blood, the number of obtained cells, preserved tissue architecture, and cellular degeneration.
  
  
  RESULTS
  The κ scores for agreement of the cytopathologic results between FNA and FNC sampling in the 4 size subgroups were 0.377, 0.455, 0.751, and 0.352 for nodules that measured ≤5.0 mm, from 5.1 to 10.0 mm, from 10.1 to 20.0 mm, and >20.0 mm, respectively. The proportion of nondiagnostic of FNAs was significantly lower than the proportion of nondiagnostic FNC samples in nodules that measured >20.0 mm (P = .037). Scores for the 4 diagnostic parameters were significantly greater in FNAs than in FNC samples in nodules that measured from 5.1 to 10.0 mm and >20.0 mm (all P < .05); however, similar results were not observed in the nodules that measured ≤5.0 mm or from 10.1 to 20.0 mm (all P > .05). Also, FNA yielded significantly more diagnostically superior specimens than FNC sampling in nodules that measured from 5.1 to 10.0 mm and >20.0 mm (P < .05 for both).
  
  
  CONCLUSIONS
  The current findings indicated that FNA may be more suitable than FNC for sampling nodules that measure from 5.1 to 10.0 mm and >20.0 mm; whereas, for nodules that measure ≤5.0 mm and from 10.1 to 20.0 mm, the 2 techniques could yield specimens with similar quality.
authors.affiliation: Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jian-Qiao
authors.initials: JQ
authors.lastname: Zhou
authors.forename: Jing-Wen
authors.initials: JW
authors.lastname: Zhang
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Zhan
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Ting-Jun
authors.initials: TJ
authors.lastname: Ye
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.forename: Jie-Jie
authors.initials: JJ
authors.lastname: Yao
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Yun-Yun
authors.initials: YY
authors.lastname: Hu
authors.forename: Edward G
authors.initials: EG
authors.lastname: Grant
mesh_terms: D000293:Adolescent; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D001707:Biopsy, Needle / Q000379:methods; D002196:Capillaries / Q000473:pathology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D018709:Statistics, Nonparametric; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology*; D016606:Thyroid Nodule / Q000098:blood supply / Q000473:pathology*; D047368:Tumor Burden; D055815:Young Adult
keywords: cytopathology; fine-needle aspiration; fine-needle capillary; thyroid nodule