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Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules <10 mm in the maximum diameter: does size matter?

Authors Lyu Y, Shen F, Yan Y, Situ M, Wu W, Jiang G, Chen Y

Received 1 October 2018

Accepted for publication 8 January 2019

Published 7 February 2019 Volume 2019:11 Pages 1231—1236


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Chien-Feng Li

Yi-jun Lyu,1,2,* Fang Shen,3,* Yun Yan,4,5 Ming-zhu Situ,4,5 Wei-zhu Wu,1,2 Guo-qiang Jiang,3 Ya-ya Chen4,5

1Department of Thyroid and Breast Surgery, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315040, Zhejiang, China; 2Department of Thyroid and Breast Surgery, Taipei Medical University Ningbo Medical Center, Ningbo 315040, Zhejiang, China; 3Department of Orthopaedic Surgery’s Spine Division, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, China; 4Department of Ultrasound, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315040, Zhejiang, China; 5Department of Ultrasound, Taipei Medical University Ningbo Medical Center, Ningbo 315040, Zhejiang, China

*These authors contributed equally to this work

Objective: Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) is a safe and effective method of screening malignant thyroid nodules such as papillary thyroid carcinoma. However, not much data are available regarding the diagnostic efficacy of US-FNAB for papillary thyroid microcarcinoma (≤10 mm in diameter). We aim to compare the diagnostic efficacy of US-FNAB on thyroid nodules between two groups divided by a diameter of 10 mm by correlating the cytological results of US-FNAB with the histopathologic diagnoses in selected patients.
Patients and methods: Eight hundred twenty-two thyroid nodules (Group A: diameter ≤10 mm, n=620; Group B: diameter >10 mm, n=202) from 797 patients treated between March 2014 and June 2017 were retrospectively evaluated. Only nodules with Thyroid Imaging Reporting and Data System (TIRADS) categories 4–6 were enrolled and sampled by US-FNAB, followed by surgical resection.
Results: According to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) diagnostic categories, 94 thyroid nodules were classified as I, III and IV, and were excluded from the analysis. The resultant 728 thyroid nodules from 721 patients were analyzed. The malignant tendency (TBSRTC V and VI) rates on US-FNAB were 88.2% and 84.6% (P=0.202) in Group A and Group B, respectively, and the malignant rates were 89.5% and 86.9% (P=0.330), respectively, on histopathology. There was a high concordance between cytology and histopathology diagnoses (kappa value =0.797), and no statistical difference in terms of US-FNAB accuracy was found between the two groups (P=0.533).
Conclusion: For thyroid nodules of TIRADS category 4–6, the diagnostic efficacy of US-FNAB is similar for thyroid nodules either smaller or greater than 10 mm in their maximum diameter.

Keywords: ultrasound-guided fine-needle aspiration biopsy, thyroid nodules, microcarcinoma, histopathology, cytopathology

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