title: Comparison of diagnostic yield of core-needle and fine-needle aspiration biopsies of thyroid lesions: Systematic review and meta-analysis.
abstract: OBJECTIVE
  Thyroid nodular disease is one of the most commonly observed medical conditions. Cytological evaluation of the specimens obtained with fine-needle aspiration biopsy (FNAB) is the most accurate tool for selecting nodules which should be further surgically removed. A major limitation of this method is the high occurrence of non-diagnostic results. This indicates the need for improvement of the thyroid biopsy technique. The aim of this meta-analysis was to compare the diagnostic value of thyroid core-needle biopsies (CNBs) and FNABs.
  
  
  METHODS
  PubMed/MEDLINE, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched. Risk ratios (RRs) of non-diagnostic results were meta-analysed using the random-effects model.
  
  
  RESULTS
  Eleven studies were included in the quantitative analysis. CNB yielded significantly more diagnostic results - the pooled risk ratio (RR) of gaining a non-diagnostic result was 0.27 (p<0.0001). For lesions with one previous non-diagnostic FNAB, RR was 0.22 (p<0.0001).
  
  
  CONCLUSIONS
  CNB seems to be a valuable diagnostic technique yielding a higher proportion of diagnostic results than conventional FNAB. It is also significantly more effective in case of nodules with a prior non-diagnostic result of FNAB results than repeated FNABs.
  
  
  CONCLUSIONS
  • Core-needle biopsy yields a higher proportion of diagnostic results than fine-needle biopsy. • Core-needle biopsies may decrease the amount of unnecessary thyroidectomies. • Probability of gaining non-diagnostic result using core-needle biopsy is almost four times lower.
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Przybyszewskiego 49 Str., Poznan, Poland. kosma1644@poczta.onet.pl.
authors.forename: Kosma
authors.initials: K
authors.lastname: Wolinski
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Przybyszewskiego 49 Str., Poznan, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Stangierski
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Przybyszewskiego 49 Str., Poznan, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Ruchala
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods; D062005:Biopsy, Large-Core Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000473:pathology; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology*
keywords: Biopsy; Core-needle biopsy; Fine-needle aspiration biopsy; Thyroid· Thyroid lesions