ABSTRACT
Objective
To establish the diagnostic performance of fine-needle aspiration in detecting benign and malignant neoplasm in comparison with post-thyroidectomy histopathological findings among patients who received a thyroidectomy.
Methods
Retrospective observational data collected between 2011–2021 were included from patients who received partial or total thyroidectomy. The Bethesda system was used to classify neoplasms from fine-needle aspiration procedures as benign or malignant. Sample characteristics, diagnostic accuracy, sensitivity, specificity, and predictive values were evaluated.
Results
Patients (n=360) who underwent thyroidectomy were analyzed, of whom 142 (39.4%) and 218 (60.6%) had benign and malignant neoplasms, respectively. Using the Bethesda system, 23 (6.4%) were classified as unsatisfactory result (BI), 83 (23.1%) as benign (BII), 50 (13.9%) as atypia of undetermined significance (BIII), 23 (6.4%) as suspected follicular or Hürthle cell neoplasia (BIV), 102 (28.3%) as suspected malignancy (BV) and 79 (21.9%) as malignant (BVI). The fine-needle aspiration diagnostic accuracy for carcinomas was 92%, while the sensitivity and specificity were 94.4% and 86.9%, respectively. The negative and positive predictive values were 87.9% and 93.9%, respectively.
Conclusion
Fine-needle aspiration has high diagnostic accuracy, sensitivity and specificity, and is a reliable test for distinguishing between benign and malignant thyroid pathologies.
Thyroid neoplasms; Thyroid nodule; Biopsy, fine-needle; Thyroidectomy
In Brief
After analyzing 360 patients who underwent thyroidectomy, 60.6% of neoplasms were classified as malignant. Fine-needle aspiration demonstrated reliable diagnostic parameters for distinguishing between benign and malignant thyroid nodules. Compared to histopathology, fine-needle aspiration had a diagnostic accuracy rate of 92% as well as high sensitivity and specificity.
Highlights
Considering Bethesda V and VI as malignant findings, the fine-needle aspiration accuracy was 92%.
Fine-needle aspiration showed 94.4% sensitivity and 86.9% specificity compared to histopathology.
We found a positive and negative predictive value of 93.9%and 87.9%, respectively.
When Bethesda III and IV were included as malignant, accuracy reduced to 80.1%.
