Reliability of fine needle aspiration biopsy in large thyroid nodules
Osman Bozbıyık1, Şafak Öztürk1, Mutlu Ünver1, Varlık Erol1, Ümit Bayol2, Cengiz Aydın1
1Clinic of General Surgery, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
2Clinic of Pathology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
Abstract
Objective: Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater.
Material and Methods: We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated.
Results: False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients.
Conclusion: In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high false-negativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.
This study was presented at the 6th National Endocrine Surgery Congress, 23-25 April 2013, Antalya, Turkey.
Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”, (amended in October 2013).
Informed consent was not received due to the retrospective nature of the study
Externally peer-reviewed.
Concept - O.B., C.A., U.B.; Design - C.A., U.B.; Supervision - C.A., U.B.; Resource - M.U., V.E.; Materials - S.O., M.U.; Data Collection and/or Processing - O.B., S.O., V.E.; Analysis and/or Interpretation - S.O., V.E.; Literature Search - O.B., M.U.; Writing Manuscript - O.B.; Critical Reviews - C.A.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.