Hong Kong Med J 2007;13:12-5 | Number 1, February 2007
Fine-needle aspiration cytology of thyroid nodules--how well are we doing?
YS Cheung, CM Poon, SM Mak, MWM Suen, HT Leong
Department of Surgery, North District Hospital, Po Kin Road, Sheung Shui, Hong Kong
OBJECTIVES. To review the accuracy of fine-needle aspiration cytology in diagnosing non-toxic thyroid nodules and determine what factors are predictive of malignancy in patients with indeterminate cytology results.
DESIGN. Retrospective study.
SETTING. Regional hospital, Hong Kong.
PATIENTS. Patients with non-toxic thyroid nodules undergoing thyroidectomy from December 1999 to December 2003.
MAIN OUTCOME MEASURES. Sensitivity, specificity, positive and negative predictive value of fine-needle aspiration cytology, predictive factors for malignancy in patients with indeterminate fine-needle aspiration cytology results.
RESULTS. The sensitivity, specificity, positive predictive value, and negative predictive value of fine-needle aspiration cytology were 54%, 100%, 100%, and 75% respectively. For the 92 patients with fine-needle aspiration cytology reported as 'indeterminate for malignancy' aspiration cytology subgroup (P=0.005) and age (P=0.001) were significant risk factors for diagnosing malignancy.
CONCLUSIONS. Fine-needle aspiration cytology has high positive predictive value for thyroid cancer, enabling us to 'rule-in' malignant lesions with confidence. Among those with indeterminate fine-needle aspiration cytology, atypical cell lesions and age greater than 40 years conferred increased risk of malignancy.
Key words: Biopsy, needle; Frozen sections; Predictive value of tests; Thyroid nodule
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