title: Comparison of pre-operation diagnosis of thyroid cancer with fine needle aspiration and core-needle biopsy: a meta-analysis.
abstract: BACKGROUND
  The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer.
  
  
  METHODS
  Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach.
  
  
  RESULTS
  Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (± 0.030) for FNA and 0.745 (± 0.095) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity.
  
  
  CONCLUSIONS
  FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.
authors.affiliation: Zhenjiang Key Laboratory of Molecular Endocrinology; Affiliated Hospital of Jiangsu University, Zhenjiang, China E-mail : yuli828@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Bao-Ding
authors.initials: BD
authors.lastname: Chen
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Zhu
authors.forename: Shu
authors.initials: S
authors.lastname: Wu
authors.forename: Da
authors.initials: D
authors.lastname: Wei
authors.forename: Jian-Quan
authors.initials: JQ
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Yu
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D044963:Biopsy, Fine-Needle / Q000379:methods*; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D002291:Carcinoma, Papillary; D006801:Humans; D061705:Image-Guided Biopsy; D012680:Sensitivity and Specificity; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography