The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules three centimeters or larger in size.
OBJECTIVE
Whether under ultrasonography (US) guidance or not, fine-needle aspiration biopsy (FNAB) has some limitations, particularly in larger nodules. In this study, we aimed to evaluate the diagnostic value of US-guided fine-needle aspiration biopsy (US-FNAB) in thyroid nodules equal to or larger than 3 cm.


METHODS
Data of 267 patients operated for nodular goiter in the period of January 2006 and March 2012 were reviewed retrospectively. The study group (40 males, 104 females; mean age 42.3 ± 12.3, between 17 and 71) consisted of patients with nodules with a diameter of 3 cm or larger. Patients with nodules less than 3 cm in diameter were considered as the control group (27 males, 96 females; mean age 44.4 ± 11.9, between 18 and 71).


RESULTS
For nodules smaller than 3 cm, US-FNAB had an accuracy rate of 60% and a false negativity rate of 21.9%. In nodules equal to or larger than 3 cm, the accuracy rate of US-FNAB was 80%, with a false negativity rate of 6.7%. Malignancy was observed in 16% of the study group and 42.3% of the control group.


CONCLUSIONS
This study showed that increased nodule diameter is not associated with limitations in the diagnostic value of US-FNAB. We also found that the malignancy rate was smaller for larger nodules. This finding reflects the importance of accurate and rational diagnostic work-up and clinical management for detecting malignancy and surgical decision-making.
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Rıfkı
R
Ucler
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Celil Alper
CA
Usluogulları
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Abbas Ali
AA
Tam
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Didem
D
Ozdemir
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Fevzi
F
Balkan
Department of General Surgery, Ataturk Education and Research Hospital, Ankara, Turkey.
Samet
S
Yalcın
Department of General Surgery, Ataturk Education and Research Hospital, Ankara, Turkey.
Gulten
G
Kıyak
Department of General Surgery, Ataturk Education and Research Hospital, Ankara, Turkey.
Pamir Eren
PE
Ersoy
Department of Pathology, Ataturk Education and Research Hospital, Ankara, Turkey.
Gulnur
G
Guler
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Reyhan
R
Ersoy
Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Ankara, Turkey.
Bekir
B
Cakır
D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005188:False Negative Reactions; D005260:Female; D006044:Goiter, Nodular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D047368:Tumor Burden
diagnostic accuracy; fine-needle aspiration biopsy; histopathology; thyroid nodule; ultrasonography